| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 323 WEST LAKESIDE AVENUE, SUITE 410 CLEVELAND, OH 44113 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $111K | $375 | $112K | 2.55% |
| DOMINICK R SIRACUSA3 Filed as: DOMINICK R. SIRACUSA | 225 DOLSON AVENUE, SUITE 304 MIDDLETOWN, NY 10940 | AFLAC | $7K | $72 | $7K | 6.82% |
| RUSS HEYMAN3 | 9 QUARRY DRIVE NEW CITY, NY 10956 | AFLAC | $2K | $0 | $2K | 2.18% |
| LEXI GRACE SIRACUSA3 Filed as: LEXI G. SIRACUSA AND OTHER AGENTS | PO BOX 729 MIDDLETOWN, NY 10940 | AFLAC | $2K | $0 | $2K | 1.97% |
| JASON HARTMAN3 | 10 LAKE STREET, SUITE 2 MONROE, NY 10950 | AFLAC | $958 | $0 | $958 | 0.98% |
| JMA CONSULTING SERVICES CORPORATION3 | 2 ADRIAN AVENUE APARTMENT 24C BRONX, NY 10463 | AFLAC | $710 | $0 | $710 | 0.72% |
| VINCENT TAYLOR ECHOLS3 Filed as: VINCENT JOSEPH KRILL | 225 DOLSON AVENUE, SUITE 304 MIDDLETOWN, NY 10940 | AFLAC | $625 | $40 | $665 | 0.68% |
| ARIK WARREN PAYTON3 | PO BOX 324 GLEN SPEY, NY 12737 | AFLAC | $456 | $0 | $456 | 0.46% |
| KIMBERLY ANNE CUNNINGHAM3 | 266 FERRY LANDING CIRCLE PORTSMOUTH, RI 02871 | THE PAUL REVERE LIFE INSURANCE COMPANY | $2K | $10 | $2K | 8.11% |
| PIO ANDRES ORTIZ3 Filed as: PIO ANDRES ORITZ | 5 BROOK ROAD ENFIELD, CT 06082 | THE PAUL REVERE LIFE INSURANCE COMPANY | $1K | $198 | $1K | 4.08% |
| ENROLLMENT SOLUTIONS LTD3 | 65 BURBANK ROAD SUTTON, MA 01590 | THE PAUL REVERE LIFE INSURANCE COMPANY | $719 | $4 | $723 | 2.45% |
| MJ INSURANCE3 Filed as: BRIAN STEBBINS AND VARIOUS AGENTS | 1707 NORTH HAMPTON STREET HOLYOKE, MA 01040 | THE PAUL REVERE LIFE INSURANCE COMPANY | $216 | $20 | $236 | 0.80% |
| AIKEN ENTERPRISES LLC3 | 341 GILLIGAN ROAD HUDSON, NY 12534 | THE PAUL REVERE LIFE INSURANCE COMPANY | $209 | $3 | $212 | 0.72% |
| KLUGMAN ASSOCIATES INC.3 Filed as: KLUGMAN ASSOCIATES | PO BOX 280 FERNDALE, NY 12734 | THE PAUL REVERE LIFE INSURANCE COMPANY | $135 | $0 | $135 | 0.46% |
| STEPHANIE DECHRISTOFARO3 | 1225 BLACK OAK DRIVE MURFREESBORO, TN 37128 | THE PAUL REVERE LIFE INSURANCE COMPANY | $105 | $0 | $105 | 0.36% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 300 MADISON AVENUE, 28TH FLOOR NEW YORK, NY 10017 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | $2K | $4K | 12.55% |
| DARLENE RUESS3 | 110 HADDEN STREET PEEKSKILL, NY 10566 | AFLAC | $169 | $0 | $169 | 2.96% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G. RELPH AGENCY INC. | 800 PARKER HILL DRIVE, SUITE 100 ROCHESTER, NY 14625 | AFLAC | $97 | $0 | $97 | 1.70% |
| ELLEN LOUIS3 | 161 OEARSALL DRIVE APARTMENT 5F MOUNT VERNON, NY 10552 | AFLAC | $56 | $0 | $56 | 0.98% |
| MCINERNEY GROUP LLC3 | 14 STILLMAN LANE PLEASANTVILLE, NY 10570 | AFLAC | $38 | $0 | $38 | 0.67% |
| ALVARO JAVIER MONTENEGRO3 | 5 ELYSE DRIVE NEW CITY, NY 10956 | AFLAC | $37 | $0 | $37 | 0.65% |
| DEBRA PARKER3 Filed as: DEBRA M. PARKER | 20 BOWEN STREET AUBURN, NY 13021 | AFLAC | $18 | $0 | $18 | 0.32% |
| MJ INSURANCE3 Filed as: JAMES E. THARP AND VARIOUS AGENTS | 6 PINE TREE COURT VALLEY COTTAGE, NY 10989 | AFLAC | $15 | $0 | $15 | 0.26% |
| ENROLLMENT SOLUTIONS LTD3 | 65 BURBANK ROAD SUTTON, MA 01590 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $14 | $0 | $14 | 1.38% |
| STEPHANIE DECHRISTOFARO3 | 1225 BLACK OAK DRIVE MURFREESBORO, TN 37128 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.39% |
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 | 450 | 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) | 450 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 557 | $4.4M |
| Dental(3 contracts, 3 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 557 | $4.4M |
| Vision | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 557 | $4.4M |
| Life insurance(4 contracts, 4 carriers) | THE PAUL REVERE LIFE INSURANCE COMPANY | 450 | $66K |
| Short-term disability(3 contracts, 3 carriers) | THE PAUL REVERE LIFE INSURANCE COMPANY | 27 | $36K |
| Prescription drug | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 557 | $4.4M |
| Other(5 contracts, 4 carriers) | AFLAC | 450 | $164K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 557 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.