| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AFS AGENCY3 | 185 GENESEE STREET, 2ND FLOOR UTICA, NY 13501 | MVP HEALTH CARE | $95K | — | $95K | 3.35% |
| ADIRONDACK FINANCIAL SERVICES3 | 185 GENESEE STREET UTICA, NY 13501 | THE HARTFORD | $13K | $0 | $13K | 4.32% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: CROWN RISK MANAGEMENT LLC | 432 N FRANKLIN ST SYRACUSE, NY 13204 | THE HARTFORD | $0 | $0 | $0 | 0.00% |
| ADIRONDACK FINANCIAL SERVICES3 | 185 GENESEE STREET FL 2 UTICA, NY 13501 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 11.79% |
| MELISSA PINE3 | 708 PARK AVE HERKIMER, NY 13350 | THE PAUL REVERE LIFE INSURANCE COMPANY | $970 | $2K | $3K | 11.55% |
| ADIRONDACK FINANCIAL SERVICES3 | 185 GENESEE ST STE 210 UTICA, NY 13501 | THE PAUL REVERE LIFE INSURANCE COMPANY | $3K | $0 | $3K | 11.21% |
| TRISHA TYMINSKI3 | PO BOX 439 CONSTANTIA, NY 13044 | THE PAUL REVERE LIFE INSURANCE COMPANY | $2K | $541 | $2K | 9.28% |
| KEVIN EDWARDS3 | 8332 MOYER CARRIAGE CICERO, NY 13039 | THE PAUL REVERE LIFE INSURANCE COMPANY | $715 | $1K | $2K | 8.35% |
| MEAGAN M MARTIN3 | 721 NORTH CLINTON STREET SYRACUSE, NY 13204 | THE PAUL REVERE LIFE INSURANCE COMPANY | $372 | $990 | $1K | 5.43% |
| VALERIE CELI3 | 6530 LAKESHORE RD CICERO, NY 13039 | THE PAUL REVERE LIFE INSURANCE COMPANY | $192 | $192 | $384 | 1.53% |
| RYAN DORSEY3 | 4483 MILLSTREAM DRIVE CLAY, NY 13041 | THE PAUL REVERE LIFE INSURANCE COMPANY | $269 | $18 | $287 | 1.15% |
| LUCIA DORSEY3 | 4483 MILLSTREAM DRIVE CLAY, NY 13041 | THE PAUL REVERE LIFE INSURANCE COMPANY | $88 | $0 | $88 | 0.35% |
| ANTHONY MATRONE3 | 4797 ROUTE 31 CLAY, NY 13041 | THE PAUL REVERE LIFE INSURANCE COMPANY | $17 | $2 | $19 | 0.08% |
| AFS AGENCY3 | 185 GENESEE STREET STE 210 UTICA, NY 13501 | HM LIFE INSURANCE COMPANY OF NEW YORK | $2K | $0 | $2K | 10.00% |
| JEFFERY S. KOWALSKY3 Filed as: JEFFERY S KOWALSKY | 2530 CHURCH RD SAQUOIT, NY 13456 | AFLAC | $1K | $41 | $1K | 9.14% |
| DAWN PELLERIN3 | 34 TAMARACK DR NEW HARTFORD, NY 13413 | AFLAC | $317 | $8 | $325 | 2.77% |
| JOSEPH P CALARCO3 Filed as: JOSEPH CALARCO | 63 GENESEE ST UTICA, NY 13501 | AFLAC | $293 | $12 | $305 | 2.60% |
| MICHAEL DAMSKY3 | 2113 GENESEE ST. UTICA, NY 13501 | AFLAC | $301 | $0 | $301 | 2.57% |
| LAURA BOHANNON3 | 23 S MARVINE AVE AUBURN, NY 13021 | AFLAC | $63 | $2 | $65 | 0.55% |
| SHAWN DECELLE3 | 20 WILLOW LANE WYANTSKILL, NY 12198 | AFLAC | $26 | $8 | $34 | 0.29% |
| EDWARD D YATES JR3 Filed as: EDWARD YATES JR | 2053 COUNTY ROUTE 8 OSWEGO, NY 13126 | AFLAC | $29 | $2 | $31 | 0.26% |
| RACHAEL HICKOK3 Filed as: RACHAEL JICKOK | 63 ACADEMY ST GREENWICH, NY 12834 | AFLAC | $25 | $5 | $30 | 0.26% |
| JAMES REYNOLDS3 | 10 GROVE AVE NORWICH, NY 13815 | AFLAC | $27 | $0 | $27 | 0.23% |
| WILLIAM S MATHIAS3 Filed as: WILLIAM MATHIAS | PO BOX 83 NEW HARTFORD, NY 13413 | AFLAC | $21 | $0 | $21 | 0.18% |
| AMY PETERS3 | 20 WILLOW LANE WYANTSVILLE, NY 12198 | AFLAC | $15 | $3 | $18 | 0.15% |
| BRAD JONES AND ASSOCIATES INC3 | 19 BRITISH AMERICAN BLVD LATHAM, NY 12110 | AFLAC | $16 | $0 | $16 | 0.14% |
| STEVEN DALABA3 | 405 CRAVER POINTE DR CLEMMONS, NC 27012 | AFLAC | $14 | $0 | $14 | 0.12% |
| MARY FRANCES CARLTON3 | 3824 HOGAN RD VERNON CENTER, NY 13477 | AFLAC | $12 | $0 | $12 | 0.10% |
| MELISSA ANN STEWART3 | 36 WINCOMA LN QUEENSBURY, NY 12804 | AFLAC | $8 | $3 | $11 | 0.09% |
| STEPHEN CONNORS3 | 108 HUNTSHILL RD SYRACUSE, NY 13209 | AFLAC | $8 | $0 | $8 | 0.07% |
| JEFF DALABA3 | 8500 GILLY FLOWER COURT BALDWINSVILLE, NY 13027 | AFLAC | $7 | $0 | $7 | 0.06% |
| KELLY A IRVINE3 Filed as: KELLY IRVINE | 4480 GOLDEN LAKE DR SARASOTA, FL 34233 | AFLAC | $7 | $0 | $7 | 0.06% |
| RICHARD G SHEERAN3 Filed as: RICHARD SHEERAN | 460 N FRANKLIN ST APT 402 SYRACUSE, NY 13204 | AFLAC | $7 | $0 | $7 | 0.06% |
| KEVIN MURPHY3 | 11 WILLOWBROOK TERRACE CLIFTON PARK, NY 12065 | AFLAC | $4 | $0 | $4 | 0.03% |
| DUCK & COVER NY INC3 | 17 DALAMAR CT LATHAM, NY 12110 | AFLAC | $3 | $0 | $3 | 0.03% |
| KELLY A IRVINE3 Filed as: KELLY IRVINE | 333 GLEN STREET SUITE 201 GLENS FALLS, NY 12801 | AFLAC | $3 | $0 | $3 | 0.03% |
| RANDI E RIVA3 Filed as: RANDI RIVA | 312 GALERY LN MOUNT BETHEL, PA 18343 | AFLAC | $1 | $0 | $1 | 0.01% |
| LAURIE SMITH3 | 577 TRUESDALE HILL RD LAKE GEORGE, NY 12845 | AFLAC | $0 | $0 | $0 | 0.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 117 W LIBERTY ST STE 2 ROME, NY 13441 | FIRST UNUM LIFE INSURANCE COMPANY | $15 | — | $15 | 3.61% |
| AFS AGENCY3 | 185 GENESEE STREET STE 210 UTICA, NY 13501 | HM LIFE INSURANCE COMPANY OF NEW YORK | $0 | $0 | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LIFETIME BENEFIT SOLUTIONS, INC EIN 16-1171765 | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing Service code 12 | 115 CONTINUUM DRIVE LIVERPOOL, NY 13088 | $9K |
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 | 918 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 927 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MVP HEALTH CARE | 365 | $2.8M |
| Vision(2 contracts) | HM LIFE INSURANCE COMPANY OF NEW YORK | 191 | $18K |
| Life insurance(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 208 | $63K |
| Short-term disability | THE HARTFORD | 2,432 | $305K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 208 | $38K |
| Prescription drug | MVP HEALTH CARE | 365 | $2.8M |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 208 | $49K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,432 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.