| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SECURE SOLUTION ASSOCIATES LLC3 | 20 RUE BEAU RIVAGE LAVONIA, GA 30553 | THE PAUL REVERE LIFE INSURANCE COMPANY | $3K | — | $3K | 3.16% |
| NICK DELIA3 | 105 BREWSTER DRIVE NEWARK, DE 19711 | THE PAUL REVERE LIFE INSURANCE COMPANY | $1K | — | $1K | 1.40% |
| CBNA INSURANCE AGENCY INC3 | P.O. BOX 747 TUPPER LAKE, NY 12986 | THE PAUL REVERE LIFE INSURANCE COMPANY | $917 | — | $917 | 0.88% |
| ONEGROUP NY INC3 | 706 N CLINTON ST SYRACUSE, NY 13204 | THE PAUL REVERE LIFE INSURANCE COMPANY | $710 | — | $710 | 0.68% |
| DONALD H MATSON3 | 8 ROSEWOOD DR AUBURN, NY 13021 | THE PAUL REVERE LIFE INSURANCE COMPANY | $177 | $9 | $186 | 0.18% |
| STEVEN C ELLIOTT3 | 800 STARBUCK AVE WATERTOWN, NY 13601 | THE PAUL REVERE LIFE INSURANCE COMPANY | $9 | — | $9 | 0.01% |
| SECURE SOLUTION ASSOCIATES LLC3 | 20 RUE BEAU RIVAGE LAVONIA, GA 30553 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $476 | — | $476 | 2.77% |
| NICK DELIA3 | 105 BREWSTER DRIVE NEWARK, DE 19711 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $262 | — | $262 | 1.53% |
| CBNA INSURANCE AGENCY INC3 | P.O. BOX 747 TUPPER LAKE, NY 12986 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $147 | — | $147 | 0.86% |
| ONEGROUP NY INC3 | 706 N CLINTON ST SYRACUSE, NY 13204 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $121 | — | $121 | 0.70% |
| JEFFREY GREENBLOTT3 | 4232 EMERSON PLACE VESTAL, NY 13850 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $45 | — | $45 | 0.26% |
| DONALD H MATSON3 Filed as: DONALD H MASTON | 8 ROSEWOOD DRIVE AUBURN, NY 13021 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $32 | $0 | $32 | 0.19% |
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 | 2,462 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 380 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,842 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 125 | $35K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 3,662 | $723K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 374 | $44K |
| Long-term disability | CIGNA LIFE INSURANCE CO. OF NEW YORK | 170 | $46K |
| Other(5 contracts, 4 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 3,662 | $821K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,662 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.