| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANDERSON BENEFIT SOLUTIONS3 Filed as: ANDERSON & KIME EMPLOYEE BENEFITS | 212 MAIN STREET RIDGWAY, PA 15853 | HIGHMARK INC | $23K | — | $23K | 3.19% |
| ANDERSON BENEFIT SOLUTIONS3 Filed as: ANDERSON & KIME EMPLOYEE BENEFITS | 212 MAIN STREET RIDGEWAY, PA 15853 | UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY | $6K | — | $6K | 9.98% |
| PEGGY LYNN STORMER3 | 244 MCANINCH ROAD BROOKVILLE, PA 15825 | AFLAC | $5K | — | $5K | 33.32% |
| ROBERT CORTEZ3 | 465 SOUTH 2ND AVENUE APARTMENT 1 CLARION, PA 16214 | AFLAC | $818 | — | $818 | 5.58% |
| BILLY M CRAIN3 | 57 PICKERING STREET BROOKVILLE, PA 15825 | AFLAC | $739 | — | $739 | 5.04% |
| MARIO HAIFA3 | 1195 WASHINGTON PIKE SUITE 300 BRIDGEVILLE, PA 15017 | AFLAC | $320 | — | $320 | 2.18% |
| KAREN L MICHELITSCH3 | 4020 ROUTE 28 NORTH BROOKVILLE, PA 15825 | AFLAC | $204 | — | $204 | 1.39% |
| ERIC R HOPKINS3 | 328 SOUTH STREET CLARION, PA 16214 | AFLAC | $134 | — | $134 | 0.91% |
| SHERYL SCARNATI3 | 217 NORTH 4TH STREET REYNOLDSVILLE, PA 15851 | AFLAC | $48 | — | $48 | 0.33% |
| JOHN F ADAMSKY3 | PO BOX 6164 NEW PHILADELPHIA, OH 44663 | AFLAC | $24 | — | $24 | 0.16% |
| CHRYSTA BOWSER3 | 389 MCCULLOUGH DRIVE BROOKVILLE, PA 15825 | AFLAC | $12 | — | $12 | 0.08% |
| JENNIFER STEPHENS3 | 3338 BUCKHORN ROAD KNOX, PA 16232 | AFLAC | $10 | — | $10 | 0.07% |
| ROBERT E SHREVE3 | 533 NEVADA DRIVE MCMURRAY, PA 15317 | AFLAC | $4 | — | $4 | 0.03% |
| DOMINICK J LACARIA3 | 216 ROSCOMMON PLACE MCMURRAY, PA 15317 | AFLAC | $2 | — | $2 | 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 | 99 | 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) | 99 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK INC | 106 | $711K |
| Dental | UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY | 116 | $60K |
| Vision | HIGHMARK INC | 106 | $711K |
| Prescription drug | HIGHMARK INC | 106 | $711K |
| Other | AFLAC | 15 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 116 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.