| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 323 WEST LAKESIDE AVENUE SUITE 410 CLEAVELAND, OH 44113 | EMPIRE HEALTHCHOICE ASSURANCE INC | $46K | $1K | $47K | 3.38% |
| RACHAEL HICKOK3 | 63 ACADEMY ST GREENWICH, NY 12834 | AFLAC | $4K | $263 | $4K | 5.71% |
| DALTON SCOTT DREW3 Filed as: DALTON DREW | 63 ACADEMY ST GREENWICH, NY 12834 | AFLAC | $1K | $38 | $1K | 1.86% |
| SARAH HUNT3 | 320 LAKE DR NORTH BENNINGTON, VT 05257 | AFLAC | $1K | — | $1K | 1.53% |
| COLIN J FUCCI3 Filed as: COLIN FUCCI | 459 PORTLAND ST STE 105 ST JOHNSBURY, VT 05819 | AFLAC | $738 | $68 | $806 | 1.14% |
| JOSEPH FOXLEY3 | 2660 RAINIER PL WEST LINN, OR 97068 | AFLAC | $479 | — | $479 | 0.68% |
| DENNIS FENNELL3 | 8 BELVOIR DR WASHINGTONVILLE, NY 10992 | AFLAC | $388 | — | $388 | 0.55% |
| AMY PETERS3 | 20 WILLOW LN WYNANTSKILL, NY 12198 | AFLAC | $280 | $6 | $286 | 0.40% |
| FLOYD AMIDON3 | 160 BENMONT AVE STE 203 BENNINGTON, VT 05201 | AFLAC | $251 | — | $251 | 0.35% |
| CHARLES REUTEMANN3 | 1407 ROUTE 9 STE 4 CLIFTON PARK, NY 12065 | AFLAC | $191 | — | $191 | 0.27% |
| THE ESTATE OF DANA E ERO3 Filed as: ESTATE OF DANA E ERO | 174 MAIN ST PO BOX 322 SCHAGHTICOKE, NY 12154 | AFLAC | $145 | — | $145 | 0.20% |
| BETH SERFILIPPI3 | 8 HILLSTONE CT BALLSTON LAKE, NY 12019 | AFLAC | $109 | $15 | $124 | 0.18% |
| ANTHONY S ALMODOVAR3 Filed as: ANTHONY R ORGERA INC | 35 PINELAWN RD STE 190 MELVILLE, NY 11747 | AFLAC | $110 | — | $110 | 0.16% |
| JASON SALLEMI3 | 302 MONROE ST APT4B HOBOKEN, NJ 07030 | AFLAC | $98 | — | $98 | 0.14% |
| ANDREW HUNT3 Filed as: ANDREW F HUNT | 320 LAKE DR NORTH BENNINGTON, VT 05257 | AFLAC | $86 | — | $86 | 0.12% |
| TRICIA TANNER3 | 124 PETERS RD GANSEVOORT, NY 12831 | AFLAC | $60 | — | $60 | 0.08% |
| BARBARA ANN BLAKE3 Filed as: BARBARA BLAKE | 110W 86TH ST APT 12D NEW YORK, NY 10024 | AFLAC | $57 | — | $57 | 0.08% |
| TREVOR FENNELL3 | 7 HIGHLAND LN EAST HAMPTON, NY 11937 | AFLAC | $50 | — | $50 | 0.07% |
| RICHARD WHELAN3 | 3887 NW 52ND ST BOCA RATON, FL 33496 | AFLAC | $36 | — | $36 | 0.05% |
| DANIELLE M BRANCATO HOUSE3 | 21 THROROUGHBRED DR SARATOGA SPRINGS, NY 12866 | AFLAC | $25 | $4 | $29 | 0.04% |
| KENNETH C MEIER CORP3 | 19 MARKWOOD RD GARDEN CITY, NY 11530 | AFLAC | $27 | — | $27 | 0.04% |
| RONALD J MOGG JR3 Filed as: RONALD MOGG JR | 184 OLD MAMARONECK RD WHITE PLAINS, NY 10605 | AFLAC | $25 | — | $25 | 0.04% |
| TIMOTHY CAVAZOS3 | 11551 NUCKOLS RD STE P GLEN ALLEN, VA 23059 | AFLAC | $23 | — | $23 | 0.03% |
| NICHOLAS MCELROY3 | PO BOX 1068 MONROE, NY 10949 | AFLAC | $23 | — | $23 | 0.03% |
| BENITO A ROTONDI II INC3 | 23 PINE RIDGE RD SARATOGA SPRINGS, NY 12866 | AFLAC | $22 | — | $22 | 0.03% |
| JASMYN YAKUBEC3 | 4249 STATE ROUTE 29 SALEM, NY 12865 | AFLAC | $20 | — | $20 | 0.03% |
| KRISTA ANNE ROTONDI3 Filed as: KRISTA ROTONDI | 5 HEMPLE PL STE 220 BALLSTON SPA, NY 12020 | AFLAC | $14 | $4 | $18 | 0.03% |
| BRAD JONES AND ASSOCIATES INC3 Filed as: BRAD JONES AND ASSOCIATIES INC | 19 BRITISH AMERICAN BLVD LATHAM, NY 12110 | AFLAC | $16 | — | $16 | 0.02% |
| CATHY HEDBERG3 | 663 WESTERN AVE ALBANY, NY 12203 | AFLAC | $14 | — | $14 | 0.02% |
| PATRICK RUHLE3 Filed as: PATRICK HARDIE | 14 WALL ST STE 8C NEW YORK, NY 10005 | AFLAC | $13 | — | $13 | 0.02% |
| JASON HARTMAN3 | 10 LAKE ST STE 2 MONROE, NY 10950 | AFLAC | $12 | — | $12 | 0.02% |
| BRIAN WHITE3 | 6 COWDIN LN CHAPPAQUA, NY 10514 | AFLAC | $10 | — | $10 | 0.01% |
| NICHOLAS PETERSON3 | 3333 BROADWAY APT C17H NEW YORK, NY 10031 | AFLAC | $10 | — | $10 | 0.01% |
| TEENA FOSTER3 | 69 PAINT WORKS RD BRANDON, VT 05733 | AFLAC | $9 | — | $9 | 0.01% |
| SUTHERLAND GLOBAL SERVICES INC3 | 1160 PITTSFORD VICTOR RD STE A PITTSFORD, NY 14534 | AFLAC | $9 | — | $9 | 0.01% |
| LISA J BRENNAN-JONES3 Filed as: LISA BRENNAN-JONES | 1014 CATHERINE WOODS SCHENECTADY, NY 12309 | AFLAC | $8 | — | $8 | 0.01% |
| ANTHONY LIBECCI3 | 4864 ARTHUR KILL RD STE 3 STATEN ISLAND, NY 10309 | AFLAC | $8 | — | $8 | 0.01% |
| MCINERNEY GROUP LLC3 | 580 WHITE PLAINS RD STE 115 TARRYTOWN, NY 10591 | AFLAC | $6 | — | $6 | 0.01% |
| KELLY A IRVINE3 Filed as: KELLY IRVINE | 15801 WHITE ORCHID LN FORT MYERS, FL 33908 | AFLAC | $6 | — | $6 | 0.01% |
| KEVIN MURPHY3 | 11 WILLOWBROOK TER CLIFTON PARK, NY 12065 | AFLAC | $5 | — | $5 | 0.01% |
| JEFF DALABA3 | 8500 GILLY GLOWER CT BALDWINSVILLE, NY 13027 | AFLAC | $3 | — | $3 | 0.00% |
| KEVIN MCCARTHY3 | 197 LANG DR NORTH KINGSTON, RI 02852 | AFLAC | $2 | — | $2 | 0.00% |
| LAURIE L SMITH3 | 57 TRUESDALE HILL RD LAKE GEORGE, NY 12845 | AFLAC | $1 | — | $1 | 0.00% |
| TOMAS E FLORES3 | 2030 HUDSON ST APT 942 FORT LEE, NJ 07024 | AFLAC | $1 | — | $1 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 323 WEST LAKESIDE AVENUE SUITE 410 CLEAVELAND, OH 44113 | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | $3K | $480 | $3K | 17.05% |
| RACHAEL HICKOK3 | 63 ACADEMY ST GREENWICH, NY 12834 | AFLAC | $563 | $28 | $591 | 6.20% |
| SARAH HUNT3 Filed as: SARAH F HUNT | 320 LAKE DR NORTH BENNINGTON, VT 05257 | AFLAC | $109 | — | $109 | 1.14% |
| THE ESTATE OF DANA E ERO3 | 5 PINE WEST PLAZA STE 503 ALBANY, NY 12205 | AFLAC | $85 | — | $85 | 0.89% |
| AMY PETERS3 | 20 WILLOW LN WYNANTSKILL, NY 12198 | AFLAC | $54 | $2 | $56 | 0.59% |
| JASMYN YAKUBEC3 | 4249 STATE ROUTE 29 SALEM, NY 12865 | AFLAC | $51 | — | $51 | 0.54% |
| STONYBROOK FINANCIAL SERVICES3 | PO BOX 1 ST JOHNSBURY, VT 05819 | AFLAC | $48 | — | $48 | 0.50% |
| PHILLIP M GERKEN JR3 | 9529 FORD RD PERRYSBURG, OH 43551 | AFLAC | $41 | — | $41 | 0.43% |
| FLOYD AMIDON3 | 160 BENMONT AVE STE 203 BENNINGTON, VT 05201 | AFLAC | $37 | — | $37 | 0.39% |
| SUZANNE I LOGAN3 | PO BOX 225 LIVINGSTON, NY 12541 | AFLAC | $35 | — | $35 | 0.37% |
| TRACEY H BOURDON3 | 4866 MANDOLIN CT WINTER HAVEN, FL 33884 | AFLAC | $31 | — | $31 | 0.33% |
| ANDREW HUNT3 Filed as: ANDREW W HUNT | 320 LAKE DR NORTH BENNINGTON, VT 05257 | AFLAC | $27 | — | $27 | 0.28% |
| MARK A TOPOLSKI3 | 5045 SAN LUIS REY DR SYLVANIA, OH 43560 | AFLAC | $20 | — | $20 | 0.21% |
| COLIN J FUCCI3 | PO BOX 1 ST JOHNSBURY, VT 05819 | AFLAC | $20 | — | $20 | 0.21% |
| AARON K BADEN3 | 73 SOUTH ST GREAT BARRINGTON, MA 01230 | AFLAC | $11 | — | $11 | 0.12% |
| CHAD A POLLOCK3 | 6506 ANTHONY DR MAUMEE, OH 43537 | AFLAC | $10 | — | $10 | 0.10% |
| MICHAEL G RYAN3 | PO BOX 60 CHROMO, CO 81128 | AFLAC | $6 | — | $6 | 0.06% |
| TRICIA TANNER3 | 124 PETERS RD GANSEVOORT, NY 12831 | AFLAC | $4 | — | $4 | 0.04% |
| BRIAN J DAY3 | 13189 HITCHING POST RD DEWITT, MI 48820 | AFLAC | $3 | — | $3 | 0.03% |
| SUSAN C BRIMHALL3 | PO BOX 8 LAKE PLACID, NY 12946 | AFLAC | $3 | — | $3 | 0.03% |
| SCOTT W GAGE3 | PO BOX 1 BOUCKVILLE, NY 13310 | AFLAC | $3 | — | $3 | 0.03% |
| RUSSELL T BARRETT3 | 27 JULIANS WAY SARATOGA SPRINGS, NY 12866 | AFLAC | $1 | — | $1 | 0.01% |
| SHAWN M MCDERMOTT3 Filed as: SHAWN MCDERMOTT | 9543 CONKLIN AVE CINCINNATI, OH 45242 | AFLAC | $1 | — | $1 | 0.01% |
| MICHAEL J LAMOUREUX3 | 425 UNON ST STE16 WEST SPRINGFIELD, MA 01089 | AFLAC | $1 | — | $1 | 0.01% |
| IAN B BRANYON3 | 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% |
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 | 135 | 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) | 135 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE INC | 92 | $1.4M |
| Dental | EMPIRE HEALTHCHOICE ASSURANCE INC | 92 | $1.4M |
| Vision | EMPIRE HEALTHCHOICE ASSURANCE INC | 92 | $1.4M |
| Life insurance | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 137 | $20K |
| Short-term disability(2 contracts) | AFLAC | 45 | $80K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 137 | — |
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.