| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMERICAN INSURANCE ADMINISTRATORS3 | 4550 LENA DRIVE, SUITE 301 MECHANICSBURG, PA 17055 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $83K | $0 | $83K | 2.58% |
| AMERICAN INSURANCE ADMINISTRATORS3 | 4550 LENA DRIVE, SUITE 301 MECHANICSBURG, PA 17055 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $18 | $2K | 1.76% |
| SUSAN R MCSHERRY3 Filed as: SUSAN R. MCSHERRY | 1330 BRIARGATE DRIVE YORK, PA 17404 | AFLAC | $5K | $18 | $5K | 7.36% |
| AMERICAN INSURANCE ADMINISTRATORS3 | 4550 LENA DRIVE, SUITE 301 MECHANICSBURG, PA 17055 | AFLAC | $4K | $0 | $4K | 5.41% |
| MJ INSURANCE3 Filed as: ADAM LEVINE AND VARIOUS AGENTS | 200 BUTLER AVENUE, SUITE 200 LANCASTER, PA 17601 | AFLAC | $3K | $4 | $3K | 3.70% |
| KL GOOD BENEFITS LLC3 | 230 DANIELLE COURT YORK, PA 17404 | AFLAC | $2K | $0 | $2K | 2.48% |
| C A LUPP INC3 Filed as: C A LUPP INC. | 940 EAST PARK DRIVE, SUITE 300 HARRISBURG, PA 17111 | AFLAC | $1K | $0 | $1K | 1.51% |
| ANTHONY S ALMODOVAR3 Filed as: ANTHONY S. ALMODOVAR | 3605 VARTAN WAY, SUITE 304 HARRISBURG, PA 17110 | AFLAC | $940 | $4 | $944 | 1.33% |
| HARRY S GOOD3 Filed as: HARRY S. GOOD | PO BOX 175 LOGANVILLE, PA 17342 | AFLAC | $526 | $0 | $526 | 0.74% |
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 | 500 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 505 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CAPITAL ADVANTAGE ASSURANCE COMPANY | 500 | $3.2M |
| Vision | VISION BENEFITS OF AMERICA | 302 | $29K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 478 | $118K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 478 | $118K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 478 | $118K |
| Prescription drug(2 contracts, 2 carriers) | CAPITAL ADVANTAGE ASSURANCE COMPANY | 500 | $3.2M |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 478 | $189K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 500 | — |
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.