| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT H PETROCELLI3 Filed as: ROBERT H. PETROCELLI JR. | 120 BROADWAY, FL 29 NEW YORK, NY 10271 | GUARDIAN | $0 | $15K | $15K | 1.29% |
| ROBERT H PETROCELLI3 Filed as: ROBERT H. PETROCELLI JR. | 120 BROADWAY, FL 29 NEW YORK, NY 10271 | MASS MUTUAL LIFE INSURANCE CO. | $38K | $4K | $42K | 13.71% |
| PETER S NOVAK3 | 330 WHITNEY AVE, SUITE 600 HOLYOKE, MA 01040 | MASS MUTUAL LIFE INSURANCE CO. | $5K | $1K | $7K | 2.13% |
| HOWARD B. COWAN3 Filed as: HOWARD B COWAN | 530 5TH AVE, FL 14 NEW YORK, NY 10036 | MASS MUTUAL LIFE INSURANCE CO. | $3K | — | $3K | 0.92% |
| BRENDAN C NAUGHTON3 Filed as: BRENDAN NAUGHTON | 501 MERRITT 7 NORWALK, CT 06851 | MASS MUTUAL LIFE INSURANCE CO. | $2K | — | $2K | 0.57% |
| MICHAEL A BOOK3 Filed as: MICHAEL BOOK | 530 5TH AVENUE NEW YORK, NY 10036 | MASS MUTUAL LIFE INSURANCE CO. | — | $7 | $7 | 0.00% |
| ROBERT H PETROCELLI3 Filed as: ROBERT H. PETROCELLI JR. | 120 BROADWAY, FL 29 NEW YORK, NY 10271 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 5.56% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVENUE HARTFORD, CT 06156 | $954K |
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 | 1,996 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,996 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN | 1,996 | $1.2M |
| Life insurance | GUARDIAN | 1,996 | $1.2M |
| Short-term disability | GUARDIAN | 1,996 | $1.2M |
| Long-term disability(2 contracts, 2 carriers) | GUARDIAN | 1,996 | $1.5M |
| Other(2 contracts, 2 carriers) | GUARDIAN | 1,996 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,996 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.