| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 4000 MIDLANTIC DRIVE, SUITE 300 MOUNT LAUREL, NJ 08054 | HORIZON HEALTHCARE SERVICES, INC. | $46K | — | $46K | 2.75% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 8TH FLOOR ITASCA, IL 60143 | USABLE LIFE | $7K | — | $7K | 13.27% |
| HORIZON INSURANCE COMPANY3 | THREE PENN PLAZA EAST M2H NEWARK, NJ 07105 | USABLE LIFE | — | $5K | $5K | 9.16% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 501 FELLOWSHIP ROAD, SUITE 201 MOUNT LAUREL, NJ 08054 | FOUR EVER LIFE INSURANCE COMPANY | $1K | — | $1K | 8.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4000 MIDLANTIC DRIVE MOUNT LAUREL, NJ 08054 | VISION SERVICE PLAN | $810 | — | $810 | 6.93% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | AFLAC | $399 | — | $399 | 8.13% |
| SHELLY J. CAMPO3 Filed as: SHELLY J CAMPO | PO BOX 84 GREEN LANE, PA 18054 | AFLAC | $324 | $58 | $382 | 7.79% |
| SVETLANA ZEITLIN3 | 105 ADDIS DRIVE CHURCHVILLE, PA 18966 | AFLAC | $210 | $81 | $291 | 5.93% |
| EDWARD F MROWKA JR3 Filed as: EDWARD MROWKA JR. | 5106 TIMBER LANE SCHNECKSVILLE, PA 18078 | AFLAC | $83 | — | $83 | 1.69% |
| JOSE A SCHIENEMAN3 | 1020 NORTH DELAWARE AVENUE 4TH FLOOR PHILADELPHIA, PA 19125 | AFLAC | $53 | $23 | $76 | 1.55% |
| JACQUELINE EBERZ3 | 4949 LIBERTY LANE, SUITE 310 ALLENTOWN, PA 18106 | AFLAC | $53 | — | $53 | 1.08% |
| MJ INSURANCE3 Filed as: RYAN GOLDBERG AND VARIOUS AGENTS | 103 CHURCH STREET, SUITE 3 PHILADELPHIA, PA 19106 | AFLAC | $1 | — | $1 | 0.02% |
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 | 108 | 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) | 108 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | HORIZON HEALTHCARE SERVICES, INC. | 111 | $1.7M |
| Dental | HORIZON HEALTHCARE SERVICES, INC. | 111 | $1.7M |
| Vision | VISION SERVICE PLAN | 69 | $12K |
| Life insurance | USABLE LIFE | 104 | $51K |
| Short-term disability | AFLAC | 10 | $5K |
| Long-term disability | USABLE LIFE | 104 | $51K |
| Prescription drug | HORIZON HEALTHCARE SERVICES, INC. | 111 | $1.7M |
| Other | USABLE LIFE | 104 | $51K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 111 | — |
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.