| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC. Filed as: GALLAGHER BENEFIT SERVICES INC. | PO BOX 95287 CHICAGO, IL 60694 | HIGHMARK WESTEN AND NORTHEASTERN NEW YORK | $36K | — | $36K | 3.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 323 WEST LAKESIDE AVENUE SUITE 410 CLEAVELAND, OH 44113 | ANTHEM BLUE CROSS BLUE SHIELD | $2K | $408 | $3K | 5.77% |
| RACHAEL HICKOK3 | 63 ACADEMY STREET GREENWICH, NY 12834 | AFLAC | $5K | $116 | $5K | 11.06% |
| DALTON SCOTT DREW3 | 63 ACADEMY ST GREENWICH, NY 12834 | AFLAC | $3K | $17 | $3K | 7.15% |
| MATTHEW BYERS3 | 45 TANNERS LN RENSSELAER, NY 12144 | AFLAC | $1K | — | $1K | 3.20% |
| AMY PETERS3 | 20 WILLOW LN WYNANTSKILL, NY 12198 | AFLAC | $953 | $17 | $970 | 2.25% |
| SARAH HUNT3 | 320 LAKE DR NORTH BENNINGTON, VT 05257 | AFLAC | $263 | — | $263 | 0.61% |
| DENNIS FENNELL3 | 8 BELVOIR DR WASHINGTONVILLE, NY 10992 | AFLAC | $193 | — | $193 | 0.45% |
| COLIN J FUCCI3 Filed as: COLIN FUCCI | 459 PORTLAND ST STE 105 ST. JOHNSBURY, VT 05819 | AFLAC | $178 | — | $178 | 0.41% |
| JOSEPH P CALARCO3 Filed as: JOSEPH PATRICK FOXLEY | 2660 RAINIER PL WEST LINN, OR 97068 | AFLAC | $155 | — | $155 | 0.36% |
| BARBARA ANN BLAKE3 | 110 W 86TH ST APT 12D NEW YORK, NY 10024 | AFLAC | $120 | — | $120 | 0.28% |
| FLOYD AMIDON3 | 160 BENMONT AVE STE 203 BENNINGTON, VT 05201 | AFLAC | $74 | — | $74 | 0.17% |
| ANTHONY ORGERA3 Filed as: ANTHONY ORGERA INC | 35 PINELAWN RD STE 190 MELVILLE, NY 11747 | AFLAC | $44 | — | $44 | 0.10% |
| RICHARD WHELAN3 | 3887 NW 52ND ST BOCA RATON, FL 33496 | AFLAC | $33 | — | $33 | 0.08% |
| TRICIA TANNER3 | 124 PETERS RD GANSEVOORT, NY 12831 | AFLAC | $26 | — | $26 | 0.06% |
| RONALD J MOGG JR3 | 184 OLD MAMARONECK RD WHITE PLAINS, NY 10605 | AFLAC | $24 | — | $24 | 0.06% |
| TREVOR FENNELL3 | 7 HIGHLAND LN EAST HAMPTON, NY 11937 | AFLAC | $22 | — | $22 | 0.05% |
| ANDREW HUNT3 | 320 LAKE DR NORTH BENNINGTON, VT 05257 | AFLAC | $16 | — | $16 | 0.04% |
| JASON SALLEMI3 | 302 MONROE ST APT 4B HOBOKEN, NJ 07030 | AFLAC | $16 | — | $16 | 0.04% |
| JASMYN YAKUBEC3 | 4249 STATE ROUTE 29 SALEM, NY 12865 | AFLAC | $14 | — | $14 | 0.03% |
| KENNETH MEIER3 Filed as: KENNETH MEIER CORP | 19 MARKWOOD RD GARDEN CITY, NY 11530 | AFLAC | $13 | — | $13 | 0.03% |
| BETH SERFILIPPI3 Filed as: BETH SERFLIPPI | 8 HILLSTONE CT BALLSTON LAKE, NY 12019 | AFLAC | $11 | — | $11 | 0.03% |
| BRAD JONES AND ASSOCIATES INC3 | 19 BRITISH AMERICAN BLVD W LATHAM, NY 12110 | AFLAC | $10 | — | $10 | 0.02% |
| BENITO A ROTONDI II INC3 Filed as: BENITO ROTONDI II INC | 23 PINE RIDGE RD SARATOGA SPRINGS, NY 12866 | AFLAC | $10 | — | $10 | 0.02% |
| CATHY HEDBERG3 | 25 STARBUCK DR UNIT 409 TROY, NY 12183 | AFLAC | $8 | — | $8 | 0.02% |
| LISA J BRENNAN-JONES3 Filed as: LISA BRENNAN JONES | 29 OAK LN LAKE GEORGE, NY 12845 | AFLAC | $5 | — | $5 | 0.01% |
| KELLY A IRVINE3 Filed as: KELLY IRVINE | 15804 WHITE ORCHID LN FORT MYERS, FL 33908 | AFLAC | $4 | — | $4 | 0.01% |
| BRIAN WHITE3 | 6 COWDIN LN CHAPPAQUA, NY 10514 | AFLAC | $3 | — | $3 | 0.01% |
| KEVIN MURPHY3 | 11 WILLOWBROOK TER CLIFTON PARK, NY 12065 | AFLAC | $3 | — | $3 | 0.01% |
| JEFF DALABA3 | 8500 GILLY FLOWER CT BALDWINSVILLE, NY 13027 | AFLAC | $2 | — | $2 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 500 N BRAND BLVD STE 100 GLENDALE, CA 91203 | ANTHEM LIFE AND DISABILITY INS. CO. | $2K | $0 | $2K | 14.14% |
| RACHAEL HICKOK3 | 63 ACADEMY STREET GREENWICH, NY 12834 | AFLAC | $807 | — | $807 | 8.97% |
| DALTON SCOTT DREW3 | 63 ACADEMY STREET GREENWICH, NY 12834 | AFLAC | $178 | — | $178 | 1.98% |
| MATTHEW BYERS3 | 45 TANNERS LN RENSSELAER, NY 12144 | AFLAC | $154 | — | $154 | 1.71% |
| AMY PETERS3 | 20 WILLOW LANE WYNANTSKILL, NY 12198 | AFLAC | $138 | — | $138 | 1.53% |
| SARAH HUNT3 | 320 LAKE DRIVE NORTH BENNINGTON, VT 05257 | AFLAC | $70 | — | $70 | 0.78% |
| COLIN J FUCCI3 Filed as: COLIN FUCCI | PO BOX 1 ST. JOHNSBURY, VT 05819 | AFLAC | $55 | — | $55 | 0.61% |
| PHILLIP M GERKEN JR3 | 9529 FORD RD PERRYSBURG, OH 43551 | AFLAC | $45 | — | $45 | 0.50% |
| FLOYD AMIDON3 | 160 BENMONT AVE STE 203 BENNINGTON, VT 05201 | AFLAC | $40 | — | $40 | 0.44% |
| TRACEY H BOURDON3 Filed as: TRACEY BOURDON | 4866 MANDOLIN CT WINTER HAVEN, FL 33884 | AFLAC | $37 | — | $37 | 0.41% |
| ANDREW HUNT3 | 320 LAKE DR NORTH BENNINGTON, VT 05257 | AFLAC | $30 | — | $30 | 0.33% |
| JASMYN YAKUBEC3 | 4249 STATE ROUTE 29 SALEM, NY 12865 | AFLAC | $23 | — | $23 | 0.26% |
| MARK J MATSOCK & ASSOCIATES INC3 Filed as: MARK TOPOLSKI | 5045 SAN LUIS REY DR SYLVANIA, OH 43560 | AFLAC | $22 | — | $22 | 0.24% |
| CHAD L NELSON3 Filed as: CHAD POLLOCK | 6506 ANTHONY DR MAUMEE, OH 43537 | AFLAC | $11 | — | $11 | 0.12% |
| MICHAEL G RYAN3 Filed as: MICHAEL RYAN | PO BOX 60 CHROMO, CO 81128 | AFLAC | $7 | — | $7 | 0.08% |
| SUSAN BRIMHALL3 | PO BOX 8 LAKE PLACID, NY 12946 | AFLAC | $3 | — | $3 | 0.03% |
| BRIAN DAY3 | 3645 W CLARK RD UNIT 40 DEWITT, MI 48820 | AFLAC | $3 | — | $3 | 0.03% |
| RUSSELL T BARRETT3 | 37 JESSICA TRCE GANSEVOORT, NY 12831 | AFLAC | $1 | — | $1 | 0.01% |
| IAN B BRANYON3 Filed as: IAN BRANYON | 9300 HARRIS CORNERS PKWY STE 100 CHARLOTTE, NC 28269 | AFLAC | $1 | — | $1 | 0.01% |
| INGER M PENNINGTON3 | 1369 BERKSHIRE DR MILFORD, OH 45150 | AFLAC | $1 | — | $1 | 0.01% |
| SHAWN MARTIN MCDERMOTT3 | 9543 CONKLIN AVE CINCINNATI, OH 45242 | AFLAC | $1 | — | $1 | 0.01% |
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 | 114 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 118 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK WESTEN AND NORTHEASTERN NEW YORK | 60 | $1.0M |
| Dental | ANTHEM BLUE CROSS BLUE SHIELD | 63 | $50K |
| Vision | ANTHEM BLUE CROSS BLUE SHIELD | 63 | $50K |
| Life insurance | ANTHEM LIFE AND DISABILITY INS. CO. | 111 | $13K |
| Short-term disability(2 contracts) | AFLAC | 47 | $52K |
| Prescription drug | HIGHMARK WESTEN AND NORTHEASTERN NEW YORK | 60 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 111 | — |
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.