| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UNKNOWN3 | 11 STANWIX STREET PITTSBURGH, PA 15222 | CAPITAL DISTRICT PHYSICIAN'S HEALTH PLAN INC. | $44K | $0 | $44K | 14.49% |
| DAVID DE PAULO3 Filed as: DAVID HOGAN | 21 CONGRESS STREET, SUITE 202 SARATOGA SPRINGS, NY 12866 | CAPITAL DISTRICT PHYSICIAN'S HEALTH PLAN INC. | $12K | $0 | $12K | 3.92% |
| USI INSURANCE SERVICES LLC3 | 261 MADISON AVENUE NEW YORK, NY 10016 | AETNA LIFE INSURANCE COMPANY | $6K | $2K | $8K | 15.07% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | COMPANION LIFE INSURANCE COMPANY | $6K | $2K | $8K | 25.19% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | MUTUAL OF OMAHA INSURANCE COMPANY | $2K | $2K | $4K | 15.72% |
| USI INSURANCE SERVICES LLC3 | 75 JOHN ROBERTS ROAD BUILDING C SOUTH PORTLAND, ME 04106 | THE PAUL REVERE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 8.32% |
| BMB BENEFITS GROUP INC3 | 334 GRAY STREET HERKIMER, NY 13350 | THE PAUL REVERE LIFE INSURANCE COMPANY | $688 | $74 | $762 | 5.47% |
| DONALD H MATSON3 Filed as: DONALD H. MATSON | 8 ROSEWOOD DRIVE AUBURN, NY 13021 | THE PAUL REVERE LIFE INSURANCE COMPANY | $346 | $26 | $372 | 2.67% |
| LORRAINE RHODES3 | 4A KENSINGTON COURT CLIFTON PARK, NY 12065 | THE PAUL REVERE LIFE INSURANCE COMPANY | $320 | $0 | $320 | 2.30% |
| MELISSA PINE3 Filed as: MELISSA BEAUCHEMIN | 334 GRAY STREET HERKIMER, NY 13350 | THE PAUL REVERE LIFE INSURANCE COMPANY | $100 | $9 | $109 | 0.78% |
| BRIAN BEAUCHEMIN3 | 334 GRAY STREET HERKIMER, NY 13350 | THE PAUL REVERE LIFE INSURANCE COMPANY | $29 | $0 | $29 | 0.21% |
| B & B INSURANCE SOLUTIONS INC3 | 14716 SOUTHWEST 112 TERRACE MIAMI, FL 33196 | THE PAUL REVERE LIFE INSURANCE COMPANY | $3 | $0 | $3 | 0.02% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | $260 | $0 | $260 | 3.91% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 222 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 222 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CAPITAL DISTRICT PHYSICIAN'S HEALTH PLAN INC. | 148 | $305K |
| Dental | AETNA LIFE INSURANCE COMPANY | 182 | $56K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | 127 | $7K |
| Life insurance(2 contracts, 2 carriers) | COMPANION LIFE INSURANCE COMPANY | 111 | $55K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 111 | $23K |
| Prescription drug | CAPITAL DISTRICT PHYSICIAN'S HEALTH PLAN INC. | 148 | $305K |
| Other(2 contracts, 2 carriers) | MUTUAL OF OMAHA INSURANCE COMPANY | 111 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 182 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.