| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ELES ENTERPRISES INC3 | P.O. BOX 445 RIEGELSVILLE, PA 18077 | METROLOLITIAN LIFE INSURANCE CO | $16K | $17 | $16K | 6.74% |
| WILSON H TRANSUE3 Filed as: WILSON TRANSUE | 1487 SULLIVAN TRL TANNERSVILLE, PA 18372 | AFLAC | $2K | $96 | $2K | 8.58% |
| STEPHEN D BISSELL3 | 5465 AMANDA DRIVE LAURYS STATION, PA 18059 | AFLAC | $424 | $19 | $443 | 1.99% |
| LISA A BROMAGE3 Filed as: LISA BROMAGE | 157 SPRING STREET SCRANTON, PA 18508 | AFLAC | $188 | — | $188 | 0.85% |
| JEFFREY CHUBB3 | 520 WEST 4TH ST SUITE 1A WILLIAMSPORT, PA 17701 | AFLAC | $132 | $19 | $151 | 0.68% |
| FRED A REEDER3 Filed as: FRED A. REEDER | 380 EAST MAIN STREET LOCK HAVEN, PA 17745 | AFLAC | $116 | — | $116 | 0.52% |
| SHARON R GRANT3 | 4975 KINGSTON WAY NAPLES, FL 34119 | AFLAC | $84 | — | $84 | 0.38% |
| C A LUPP INC3 | 940 E PARK DR HARRISBURG, PA 17111 | AFLAC | $51 | — | $51 | 0.23% |
| WILLIAM M KNOTT3 Filed as: WILLIAM KNOTT | 24040 GREEN FOREST DR EUSTIS, FL 32736 | AFLAC | $43 | — | $43 | 0.19% |
| RANDALL SIMS3 | 138 DERR DR COLLEGEVILLE, PA 19426 | AFLAC | $33 | — | $33 | 0.15% |
| JOSEPH G GRABLICK3 Filed as: JOSEPH GRABLICK | 716 SUSQUEHANNA AVE WYOMING, PA 18644 | AFLAC | $32 | — | $32 | 0.14% |
| CHRISTOPHER BORNEISEN3 | 20 E JACKSON ST MCADOO, PA 18237 | AFLAC | $31 | — | $31 | 0.14% |
| MG BERGER INC3 | 1020 N DELAWARE AVE, 4TH FLOOR PHILADELPHIA, PA 19125 | AFLAC | $30 | — | $30 | 0.13% |
| BLACK ROK BENEFIT ALLIANCE LLC3 Filed as: BLACK ROCK BENEFIT ALLIANCE LLC | PO BOX 211 YOUNGWOOD, PA 15697 | AFLAC | $19 | — | $19 | 0.09% |
| BILLY M CRAIN3 | 97 PICKERING ST BROOKVILLE, PA 15825 | AFLAC | $15 | — | $15 | 0.07% |
| MARTHA G ALLEN3 | 412 WASHINGTON STREET NEW BETHLEHEM, PA 16242 | AFLAC | $15 | — | $15 | 0.07% |
| STEVEN R KARAS3 | 29 CRAFTS ST STE 550 NEWTON, MA 02458 | AFLAC | $12 | — | $12 | 0.05% |
| DIANNE L MARTIN3 Filed as: DIANNE MARTIN | 125 MANOR STREET HARRISBURG, PA 17110 | AFLAC | $10 | — | $10 | 0.04% |
| BRIAN W PATTEN3 | 120 MARGUERITE DRIVE, STE 101 CRANBERRY TOWNSHIP, PA 16066 | AFLAC | $10 | — | $10 | 0.04% |
| MARK D BARBIER3 Filed as: MARK BARBIER | 802 DEER TRAIL LANE OAK BROOK, IL 60523 | AFLAC | $7 | — | $7 | 0.03% |
| DEBRA L CARL3 | 2042 STATE ROUTE 61 SUNBURY, PA 17801 | AFLAC | $6 | — | $6 | 0.03% |
| DANIEL R JUDY3 | 231 WALTERS MILL ROAD SOMERSET, PA 15501 | AFLAC | $5 | — | $5 | 0.02% |
| DARREN D RIDDLE3 | 7850 AVONDALE TERRACE HARRISBURG, PA 17112 | AFLAC | $2 | — | $2 | 0.01% |
| IRENE E BROOKS3 Filed as: IRENE BROOKS | 833 NORTH PARK ROAD SUITE 220 READING, PA 19610 | AFLAC | $2 | — | $2 | 0.01% |
| RYAN K GOLDBERG3 | 103 CHURCH STREET, #3 PHILADELPHIA, PA 19106 | AFLAC | $1 | — | $1 | 0.00% |
| ANGELA MASSARELLI3 | 30 WATERFRONT WAY HAMMONTON, NJ 08037 | AFLAC | $1 | — | $1 | 0.00% |
| DANIEL P CLARK3 | 33 LANDAU ROAD PLAINVILLE, MA 02762 | AFLAC | $1 | — | $1 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WELLPOWER INC EIN 22-3530108 NONE | Claims processing Service code 12 | — | $27K |
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 | 176 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 177 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HIGHMARK INC- KHPW-HMO | 173 | $1.3M |
| Dental | METROLOLITIAN LIFE INSURANCE CO | 479 | $237K |
| Vision | HIGHMARK INC- VISION | 364 | $16K |
| Life insurance(2 contracts, 2 carriers) | METROLOLITIAN LIFE INSURANCE CO | 479 | $260K |
| Short-term disability | METROLOLITIAN LIFE INSURANCE CO | 479 | $237K |
| Long-term disability | METROLOLITIAN LIFE INSURANCE CO | 479 | $237K |
| Other(2 contracts, 2 carriers) | METROLOLITIAN LIFE INSURANCE CO | 479 | $260K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 479 | — |
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.