| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PROFESSIONAL GROUP PLANS INC Filed as: PROFESSIONAL GROUP PLANS | 225 WIRELESS BLVD SUITE 200 HAUPPAUGE, NY 11788 | GUARDIAN | $11K | $3K | $13K | 12.36% |
| LARRY JAY BLUM | PO BOX 254 TALLMAN, NY 10982 | AFLAC | $28K | $186 | $28K | 55.65% |
| DOMINICK R SIRACUSA | 225 DOLSON AVE SUITE 304 MIDDLETOWN, NY 10940 | AFLAC | $4K | $276 | $5K | 9.13% |
| JEAN-MARC ARCHER | 2 WOODLAND AVE MIDDLETOWN, NY 10940 | AFLAC | $2K | $226 | $2K | 4.82% |
| JASON SCZEPANIAK Filed as: JASON HARTMAN | 560 WHITE PLAINS RD SUITE 320 TARRYTOWN, NY 10591 | AFLAC | $1K | $125 | $1K | 2.51% |
| GRACE IENUSO | 96 MYERS RD NEVERSINK, NY 12765 | AFLAC | $916 | $64 | $980 | 1.93% |
| ROBERT G. RELPH AGENCY, INC. Filed as: ROBERT G RELPH AGENCY INC | 1150 G PITTSFORD VICTOR ROAD 2ND FLOOR PITTSFORD, NY 14534 | AFLAC | $467 | — | $467 | 0.92% |
| W E BRENNAN INC | 5 CORPORATE DRIVE SUITE 104 CENTRAL VALLEY, NY 10917 | AFLAC | $135 | — | $135 | 0.27% |
| MCINERNEY GROUP LLC | 580 WHITE PLAINS ROAD SUITE 600 TARRYTOWN, NY 10591 | AFLAC | $92 | — | $92 | 0.18% |
| RANDI E RIVA Filed as: RANDI RIVA | 41 BAYBERRY LANE MIDDLETOWN, NJ 07748 | AFLAC | $67 | — | $67 | 0.13% |
| JEFF DALABA | 8500 GILLY FLOWER COURT BALDWINSVILLE, NY 13027 | AFLAC | $44 | — | $44 | 0.09% |
| DEBRA PARKER | 20 BOWEN STREET AUBURN, NY 13021 | AFLAC | $42 | — | $42 | 0.08% |
| DAVID YEGELWELL | 8 MCNALLY ST GOSHEN, NY 10924 | AFLAC | $28 | — | $28 | 0.06% |
| JENNIFER LINGLE | 220 PARK LANE WARWICK, NY 10990 | AFLAC | $20 | — | $20 | 0.04% |
| HUGO D GRAJEDA | 25 WHITETAIL RUN RD CHESTER, NY 10918 | AFLAC | $14 | — | $14 | 0.03% |
| MELISSA A SCHOFIELD Filed as: MELISSA SCHOFIELD | 34 WATCH HILL DR MIDDLETOWN, CT 06457 | AFLAC | $4 | — | $4 | 0.01% |
| KEVIN MCCARTHY | 197 LANG DR NORTH KINGSTOWN, RI 02852 | AFLAC | $2 | — | $2 | 0.00% |
| WENDY CALIENDO | 1036 MAGGIE RD NEWBURGH, NY 12550 | AFLAC | $2 | — | $2 | 0.00% |
| THOMAS FLORES | 1265 15TH STREET APT 16G FORT LEE, NJ 07024 | AFLAC | $1 | — | $1 | 0.00% |
| STEVEN DALABA | 1215 PEBBLE MEADOWS DR LAKE GROVE, NY 12845 | AFLAC | $1 | — | $1 | 0.00% |
| ROBERT G. RELPH AGENCY, INC. Filed as: ROBERT G RELPH AGENCY | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | AFLAC | — | — | $0 | 0.00% |
| RANDI E RIVA | 312 GALLERY LN MOUNT BETHEL, PA 18343 | AFLAC | — | — | $0 | 0.00% |
| STEPHEN PIKUL | 81 LOWER RESERVOIR ROAD GOSHEN, NY 10924 | AFLAC | — | — | $0 | 0.00% |
| CLIFF NIER | 225 DOLSON AVE 3RD FLOOR MIDDLETOWN, NY 10940 | AFLAC | — | — | $0 | 0.00% |
| AMERICAN TEL-TEK INC. Filed as: AMERICAN TEL-TEK INC | C/O ESTELLE TOLSON 92 NORTH AVENUE SUITE 204 NEW ROCHELLE, NY 10801 | AFLAC | — | — | $0 | 0.00% |
| WALTER TOLSON | 316 S OCEAN DR APT 2 FORT PIERCE, FL 34949 | AFLAC | — | — | $0 | 0.00% |
| ANNE MARIE BEEKMAN | 22 VOSHAGE RD PINE BUSH, NY 12566 | AFLAC | — | — | $0 | 0.00% |
| NANCY A PODHRADSKY | 71 DARLING AVE NEW ROCHELLE, NY 10804 | AFLAC | — | — | $0 | 0.00% |
| GREGORY MEYER | 1741 TREDEGAR RD KERNERSVILLE, NC 27284 | AFLAC | — | — | $0 | 0.00% |
| KENNETH C MEIER CORP | 401 FRANKLIN AVENUE SUITE 312 GARDEN CITY, NY 11530 | AFLAC | — | — | $0 | 0.00% |
| CLIFF NIER | 99 RT 17A GOSHEN, NY 10924 | AFLAC | — | — | $0 | 0.00% |
| WALTER TOLSON | 30 HARDING RD GORHAM, ME 04038 | AFLAC | — | — | $0 | 0.00% |
| DEBRA PARKER | 1000 PITTSFORD-VICTOR RD PITTSFORD, NY 14534 | AFLAC | — | — | $0 | 0.00% |
| GREGORY E MEYER | 8875 HIDDEN RIVER PARKWAY #300 TAMPA, FL 33637 | AFLAC | — | — | $0 | 0.00% |
| JASON SCZEPANIAK Filed as: JASON HARTMAN | 560 WHITE PLAINS RD SUITE 320 TARRYTOWN, NY 10591 | AFLAC | — | — | $0 | 0.00% |
| ROBERT G. RELPH AGENCY, INC. Filed as: ROBERT G RELPH AGENCY | 400 WILLOWBROOK OFFICE PARK FAIRPORT, NY 144504223 | RELIASTAR LIFE INSURANCE | $167 | — | $167 | 6.13% |
| ROBERT G. RELPH AGENCY, INC. Filed as: ROBERT G RELPH AGENCY | 22113 FABCO RD WATERTOWN, NY 13601 | FIRST UNUM LIFE INSURANCE COMPANY | $263 | — | $263 | 9.81% |
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 | 221 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 221 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AFLAC | 43 | $51K |
| Dental(2 contracts, 2 carriers) | GUARDIAN | 221 | $111K |
| Vision(2 contracts, 2 carriers) | GUARDIAN | 221 | $111K |
| Life insurance(2 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE | 7 | $5K |
| Other(3 contracts, 3 carriers) | GUARDIAN | 221 | $114K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 221 | — |
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.