| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GREAT BENEFITS INC3 Filed as: GREAT BENEFITS, INC. | 125 EAST DRIVE NORTH MASSAPEQUA, NY 11758 | EMBLEMHEALTH | $37K | — | $37K | 2.80% |
| JEROME TEPPER3 | 50 BROADWAY 2ND FLOOR HAWTHORNE, NY 10532 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $6K | — | $6K | 7.34% |
| PROFESSIONAL GROUP MARKETING INC3 | 50 BROADWAY HAWTHORNE, NY 10532 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $3K | $3K | 3.97% |
| PROFESSIONAL GROUP MARKET3 | 50 BROADWAY 2ND FLOOR HAWTHORNE, NY 10583 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $1K | — | $1K | 3.08% |
| PROFESSIONAL GROUP MARKET3 | 50 BROADWAY 2ND FLOOR HAWTHORNE, NY 10583 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $2K | — | $2K | 5.42% |
| GA SOLUTIONS LLC3 | 370 LEXINGTON AVENUE SUITE 703 NEW YORK, NY 10017 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 14.18% |
| PROFESSIONAL GROUP MARKETING INC3 Filed as: PROFESSIONAL GROUP MARKETING, INC | 50 BROADWAY 2ND FLOOR HAWTHORNE, NY 10532 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $657 | $657 | 4.90% |
| GREAT BENEFITS INC3 | 125 EAST DRIVE NORTH MASSAPEQUA, NY 11758 | THE PAUL REVERE LIFE INSURANCE COMPANY | $143 | — | $143 | 1.79% |
| KIMANI MATTHEW3 | 1113 EAST 212TH STREET BRONX, NY 10469 | THE PAUL REVERE LIFE INSURANCE COMPANY | $49 | $28 | $77 | 0.96% |
| MICHELLE DARTEE3 | 12 MOONSHADOW COURT KINNELON, NJ 07405 | THE PAUL REVERE LIFE INSURANCE COMPANY | $66 | — | $66 | 0.83% |
| HOWARD HOROWITZ3 Filed as: HOWARD P DILEMA | 55 MAIN STREET WHITE PLAINS, NY 10606 | THE PAUL REVERE LIFE INSURANCE COMPANY | $37 | — | $37 | 0.46% |
| PROFESSIONAL GROUP MARKETING INC3 | ATTN JEROME TEPPER HAWTHORN, NY 10532 | THE PAUL REVERE LIFE INSURANCE COMPANY | $21 | — | $21 | 0.26% |
| HELEN DIZ-HATTON3 | 4 PALMER LANE ENGLISHTOWN, NJ 07726 | THE PAUL REVERE LIFE INSURANCE COMPANY | $16 | — | $16 | 0.20% |
| RYAN GARVIN3 | 50 MAIN STREET WHITE PLAINS, NY 10606 | THE PAUL REVERE LIFE INSURANCE COMPANY | $7 | $6 | $13 | 0.16% |
| MARK EDWARD HATHAWAY3 | 50 MAIN STREET SUITE 1000 WHITE PLAINS, NY 10606 | THE PAUL REVERE LIFE INSURANCE COMPANY | $1 | $0 | $1 | 0.01% |
| PROFESSIONAL GROUP MARKET3 | 50 BROADWAY 2ND FLOOR HAWTHORNE, NY 10583 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $267 | — | $267 | 8.00% |
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 | 130 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 133 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMBLEMHEALTH | 65 | $1.3M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 123 | $93K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 123 | $13K |
| Life insurance | CIGNA LIFE INSURANCE CO. OF NEW YORK | 130 | $42K |
| Short-term disability | THE PAUL REVERE LIFE INSURANCE COMPANY | 11 | $8K |
| Long-term disability | CIGNA LIFE INSURANCE CO. OF NEW YORK | 130 | $30K |
| Prescription drug | EMBLEMHEALTH | 65 | $1.3M |
| Other(4 contracts, 3 carriers) | CIGNA LIFE INSURANCE CO. OF NEW YORK | 130 | $67K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 130 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.