| 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 | $0 | $46K | 2.67% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4000 MIDLANTIC DRIVE MOUNT LAUREL, NJ 08054 | HORIZON HEALTHCARE SERVICES, INC. | $10K | $0 | $10K | 0.56% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | HORIZON HEALTHCARE SERVICES, INC. | $5K | $0 | $5K | 0.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 3600 AMERICAN BOULEVARD WEST SUITE 500 BLOOMINGTON, MN 55431 | USABLE LIFE | $8K | $0 | $8K | 12.76% |
| HORIZON INSURANCE COMPANY3 | 3 PENN PLAZA EAST M2H NEWARK, NJ 07105 | USABLE LIFE | $0 | $6K | $6K | 8.91% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4000 MIDLANTIC DRIVE MOUNT LAUREL, NJ 08054 | VISION SERVICE PLAN | $958 | $0 | $958 | 6.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $216 | $0 | $216 | 4.33% |
| RUSSELL L. DAYVAULT3 | 2777 MEADOWVIEW COURT TARPON SPRINGS, FL 34688 | AFLAC | $98 | $0 | $98 | 1.97% |
| SVETLANA ZEITLIN3 | 105 ADDIS DRIVE CHURCHVILLE, PA 18966 | AFLAC | $79 | $18 | $97 | 1.95% |
| SJC BUSINESS SERVICES LLC3 Filed as: SJC BUSINESS SERVICES, LLC | PO BOX 84 GREEN LANE, PA 18054 | AFLAC | $49 | $0 | $49 | 0.98% |
| JACQUELINE M EBERZ3 Filed as: JACQUELINE EBERZ AND OTHER AGENTS | 98 LAMP POST ROAD NEW BRITAIN, PA 18901 | AFLAC | $35 | $3 | $38 | 0.76% |
| EDWARD F MROWKA JR3 Filed as: EDWARD F. MROWKA JR. | 5106 TIMBER LANE SCHNECKSVILLE, PA 18078 | AFLAC | $35 | $0 | $35 | 0.70% |
| JOSE A SCHIENEMAN3 Filed as: JOSE A. SCHIENEMAN | 4515 SOUTH MCCLINTOCK DRIVE SUITE 212 TEMPE, AZ 85282 | AFLAC | $24 | $0 | $24 | 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 | 112 | 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) | 112 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HORIZON HEALTHCARE SERVICES, INC. | 108 | $1.7M |
| Dental | HORIZON HEALTHCARE SERVICES, INC. | 108 | $1.7M |
| Vision | VISION SERVICE PLAN | 86 | $16K |
| Life insurance | USABLE LIFE | 96 | $64K |
| Short-term disability | AFLAC | 6 | $5K |
| Long-term disability | USABLE LIFE | 96 | $64K |
| Prescription drug | HORIZON HEALTHCARE SERVICES, INC. | 108 | $1.7M |
| Other(3 contracts, 3 carriers) | USABLE LIFE | 112 | $71K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 112 | — |
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.