| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE AGENCY INC. | 1 EMPIRE DRIVE RENSSELAER, NY 12144 | UNITEDHEALTHCARE INSURANCE COMPANY | $72K | $250 | $72K | 2.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | UNITEDHEALTHCARE INSURANCE COMPANY | $72K | $0 | $72K | 2.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 4TH FLOOR ROLLING MEADOWS, IL 60008 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $3K | $3K | 0.08% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE AGENCY INC. | 1 EMPIRE DRIVE RENSSELAER, NY 12144 | FIRST UNUM LIFE INSURANCE COMPANY | $6K | $0 | $6K | 4.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 784 TROY SCHENECTADY ROAD LATHAM, NY 12210 | FIRST UNUM LIFE INSURANCE COMPANY | $6K | $0 | $6K | 4.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $978 | $978 | 0.67% |
| CHRISTIAN M TULLY3 Filed as: CHRISTIAN M. TULLY | 154 LAUREL ROAD EAST NORTHPORT, NY 11731 | AFLAC | $2K | $23 | $2K | 5.14% |
| B. SHANDS-CAYENNE AND OTHER AGENTS3 | 971 EAST 37TH STREET BROOKLYN, NY 11210 | AFLAC | $2K | $0 | $2K | 4.13% |
| RICHARD PETERSON3 | 19 IDLE DAY DRIVE CENTERPORT, NY 11721 | AFLAC | $647 | $12 | $659 | 1.72% |
| DAVID CUNNEELY3 | 7149 METROPOLITAN AVENUE APARTMENT 2D MIDDLE VILLAGE, NY 11379 | AFLAC | $585 | $30 | $615 | 1.60% |
| JAICYN SIMPSON3 | 13726 BEDELL STREET SPRINGFIELD GARDENS, NY 11413 | AFLAC | $459 | $0 | $459 | 1.20% |
| JASON IRISH3 | 425 MAIN STREET, APARTMENT C NORTHPORT, NY 11768 | AFLAC | $450 | $0 | $450 | 1.17% |
| BARBARA A. MEYER3 | 6 HICKORY LANE LEVITTOWN, NY 11756 | AFLAC | $367 | $0 | $367 | 0.96% |
| CHRISTIAN M TULLY3 Filed as: CHRISTIAN M. TULLY | 154 LAUREL ROAD EAST NORTHPORT, NY 11731 | AFLAC | $447 | $20 | $467 | 4.25% |
| MJ INSURANCE3 Filed as: ROBERT NIVEYRO AND VARIOUS AGENTS | PO BOX 2647 LUTZ, FL 33548 | AFLAC | $326 | $0 | $326 | 2.96% |
| JAICYN SIMPSON3 | 13726 BEDELL STREET SPRINGFIELD GARDENS, NY 11413 | AFLAC | $199 | $22 | $221 | 2.01% |
| RICHARD PETERSON3 | 19 IDLE DAY DRIVE CENTERPORT, NY 11721 | AFLAC | $133 | $9 | $142 | 1.29% |
| BARBARA A. MEYER3 | 6 HICKORY LANE LEVITTOWN, NY 11756 | AFLAC | $141 | $0 | $141 | 1.28% |
| DAVID CUNNEELY3 | 7149 METROPOLITAN AVENUE APARTMENT 2D MIDDLE VILLAGE, NY 11379 | AFLAC | $89 | $0 | $89 | 0.81% |
| SEAN FX GLEASON LLC3 | 52 HOLIDAY PARK DRIVE HAUPPAUGE, NY 11788 | AFLAC | $52 | $0 | $52 | 0.47% |
| DEANA BRENNAN3 Filed as: DEANA BRENNAN INC. AND OTHER AGENTS | 176 MAIN STREET GOSHEN, NY 10924 | AFLAC | $310 | $0 | $310 | 3.32% |
| CHRISTIAN M TULLY3 Filed as: CHRISTIAN M. TULLY | 154 LAUREL ROAD EAST NORTHPORT, NY 11731 | AFLAC | $244 | $63 | $307 | 3.29% |
| ROBERT NIVEYRO3 | PO BOX 2647 LUTZ, FL 33548 | AFLAC | $122 | $0 | $122 | 1.31% |
| MICHAEL GOLDSTEIN3 | 8823 RHEIMS ROAD BOCA RATON, FL 33496 | AFLAC | $73 | $0 | $73 | 0.78% |
| RICHARD PETERSON3 | 19 IDLE DAY DRIVE CENTERPORT, NY 11721 | AFLAC | $56 | $15 | $71 | 0.76% |
| BARBARA A. MEYER3 | 6 HICKORY LANE LEVITTOWN, NY 11756 | AFLAC | $66 | $0 | $66 | 0.71% |
| WILLIAM E BRENNAN3 Filed as: WILLIAM E. BRENNAN | PO BOX 311 SOUTHFIELDS, NY 10975 | AFLAC | $45 | $0 | $45 | 0.48% |
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 | 566 | 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) | 566 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 402 | $3.6M |
| Dental(4 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 402 | $3.6M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 402 | $3.6M |
| Life insurance | FIRST UNUM LIFE INSURANCE COMPANY | 411 | $147K |
| Short-term disability(4 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 411 | $205K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 411 | $147K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 402 | $3.6M |
| Other(5 contracts, 3 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 566 | $218K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 566 | — |
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.