| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSGROUP INC3 Filed as: MARTIN INSURANCE GROUP (2) | 259 PROSPECT PLAINS RD - BLD F, STE CRANBURY, NJ 08512 | HORIZON HEALTHCARE SERVICES, INC. | $44K | $13K | $57K | 4.40% |
| INSGROUP INC3 Filed as: MARTIN INSURANCE GROUP (2) | 259 PROSPECT PLAINS RD - BLD F, STE CRANBURY, NJ 08512 | HORIZON HEALTHCARE SERVICES, INC. | $10K | $3K | $13K | 4.40% |
| GA SOLUTIONS LLC3 | 311 CLOCK TOWER CMNS BREWSTER, NY 10509 | PRINCIPAL LIFE INSURANCE COMPANY | — | $4K | $4K | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA MITCHELL INSURANCE | AGENCY PO BOX 1788 GRAND RAPIDS, MI 49501 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | — | $3K | 4.85% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA | — | PRINCIPAL LIFE INSURANCE COMPANY | — | $621 | $621 | 0.88% |
| PROFESSIONAL GROUP PLANS INC3 | 225 WIRELESS BLVD, STE 200 HAUPPAUGE, NY 11788 | AFLAC | $1K | — | $1K | 4.04% |
| DANIEL J O BRIEN3 | 14107 20TH AVE, STE 507 WHITESTONE, NY 11357 | AFLAC | $772 | $204 | $976 | 3.22% |
| TRIBEN INSURANCE SOLUTIONS INC3 Filed as: TRIBEN INS SOLUTIONS INC | 24 E SECOND ST, APT 1 MEDIA, PA 19063 | AFLAC | $933 | — | $933 | 3.08% |
| RICHARD PETERSON3 Filed as: RICHARD D PETERSON | 19 IDLE DAY DR CENTERPORT, NY 11721 | AFLAC | $121 | $48 | $169 | 0.56% |
| MATTHEW G BERGER3 | 22 SUNNYRIDGE RD PHILADELPHIA, PA 19125 | AFLAC | $23 | — | $23 | 0.08% |
| BONNIE H DROBNES3 | 118 BEAUMONT PL LOWER GWYNEDD, PA 19002 | AFLAC | $6 | — | $6 | 0.02% |
| MAIN LINE BENEFIT SOLUTIONS LLC3 | 1405 LARKSPUR LN MALVERN, PA 19355 | AFLAC | $6 | — | $6 | 0.02% |
| WILLIAM JOHNSON3 | 471 WATERFORDS EDGE CT ATCO, NJ 08004 | AFLAC | $6 | — | $6 | 0.02% |
| JOSE A SCHIENEMAN3 | 1881 S CARRIAGE LN CHANDLER, AZ 85286 | AFLAC | $6 | — | $6 | 0.02% |
| RYAN K GOLDBERG3 | 103 CHURCH ST #3 PHILADELPHIA, PA 19106 | AFLAC | $3 | — | $3 | 0.01% |
| DARREN D RIDDLE3 | 7850 AVONDALE TER HARRISBURG, PA 17112 | AFLAC | $2 | — | $2 | 0.01% |
| ANGELA MASSARELLI3 | 30 WATERFRONT WAY HAMMONTON, NJ 08037 | AFLAC | $2 | — | $2 | 0.01% |
| DARREN D RIDDLE3 | 7850 AVONDALE TER HARRISBURG, PA 17112 | AFLAC | — | — | $0 | 0.00% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA | MITCHELL INSURANCE AGENCY 100 OTTAWA AVE, SW GRAND RAPIDS, MI 49503 | HEARTLAND | $1K | — | $1K | 10.00% |
| ACRISURE LLC3 | — | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $691 | — | $691 | 15.01% |
| HORIZON INSURANCE COMPANY3 | — | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | — | $229 | $229 | 4.97% |
| PROFESSIONAL GROUP PLANS INC3 | — | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | — | $23 | $23 | 0.50% |
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 | 131 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 131 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HORIZON HEALTHCARE SERVICES, INC. | 128 | $1.3M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 237 | $70K |
| Vision | HEARTLAND | 230 | $11K |
| Life insurance | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 218 | $5K |
| Prescription drug | HORIZON HEALTHCARE SERVICES, INC. | 67 | $286K |
| Other(2 contracts, 2 carriers) | AFLAC | 218 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 237 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.