| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MICHAEL S VANGAVREE3 | 1023 MUMMA RD STE 202 LEMOYNE, PA 17043 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $2K | $2K | 2.90% |
| CARRAIGE HOUSE INSURANCE INC3 | 404 WASHINGTON STREET HUNTINGDON, PA 16652 | VISION BENEFITS OF AMERICA | $747 | $0 | $747 | 1.53% |
| BENECHOICE ENROLLMENT SOLUTIONS3 Filed as: BENECHOICE ENROLLMENT SOLUTIONS INC | 1574 LITITZ PIKE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $631 | $24 | $655 | 4.38% |
| ASHLY ELCOCK3 | 200 TATTLETOWN ROAD AARONSBURG, PA 16820 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $390 | $8 | $398 | 2.66% |
| T NASH SKILES INC3 | 1574 LITITZ PIKE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $139 | $47 | $186 | 1.24% |
| MARK D ELCOCK3 | 227 1/2 DUQUESNE AVE TRAFFORD, PA 15085 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $89 | $0 | $89 | 0.60% |
| WILLIAM E GOOD3 | 311 BOWIE STREET AUSTIN, TX 78703 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $40 | $0 | $40 | 0.27% |
| JAMES BARTLETT LLC3 Filed as: JAMES BARTLETT | 3138 GREENRIDGE DRIVE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | $1 | $8 | 0.05% |
| RICHARD F DURR3 | 159 COOK RD DUBOIS, PA 15801 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | $0 | $7 | 0.05% |
| ELSIE M FAIRCHILD3 | 1574 LITITZ PIKE LANCASTER, PA 176016511 | AMERITAS LIFE INSURANCE CORP. | $733 | $0 | $733 | 10.86% |
| CARRIAGE HOUSE INS. AGENCY3 Filed as: CARRIAGE HOUSE INS SWIGART ASSOC IN | 404 WASHINGTON STREET HUNTINGDON, PA 16652 | HARTFORD LIFE AND ACCIDENT | $865 | $0 | $865 | 15.00% |
| MELISSA R FEATHER3 | 10940 WILLIAM PENN ROAD IMLER, PA 16655 | AFLAC | $180 | $0 | $180 | 3.49% |
| JONATHAN D FEATHER3 | 10940 WILLIAM PENN ROAD IMLER, PA 16655 | AFLAC | $90 | $0 | $90 | 1.74% |
| JENNIFER ROBIN HRIVNAK3 | 3900 INDUSTRIAL PARK DRIVE SUITE 11 ALTOONA, PR 16602 | AFLAC | $57 | $0 | $57 | 1.11% |
| DEBRA L CARL3 | 2042 STATE ROUTE 61 SUNBURY, PA 17801 | AFLAC | $34 | $0 | $34 | 0.66% |
| VICKI J VELTRI3 | 1175 BALKAN DR PITTSBURGH, PA 15239 | AFLAC | $31 | $0 | $31 | 0.60% |
| JOHN E HRIVNAK3 | 3900 INDUSTRIAL PARK DR, SUITE 11 ALTOONA, PA 16602 | AFLAC | $30 | $0 | $30 | 0.58% |
| MARIO HAIFA3 | 1195 WASHINGTON PIKE SUITE 300 BRIDGEVILLE, PA 15017 | AFLAC | $23 | $0 | $23 | 0.45% |
| KIMMON R GUSEMAN3 Filed as: KIMMON R GUSMAN | 48 NICKMAN PLAZA LEMONT FURNACE, PA 15456 | AFLAC | $13 | $0 | $13 | 0.25% |
| LEE ANN M. KLINE3 Filed as: LEE ANN M KLINE | 708 WOODLAND DRIVE PITTSBURGH, PA 15238 | AFLAC | $13 | $0 | $13 | 0.25% |
| TYE ELLIOTT3 | 1300 N INDEPENDENCE CT GERMANTOWN HILLS, IL 61548 | AFLAC | $10 | $0 | $10 | 0.19% |
| BRIAN W PATTEN3 | 120 MARGUERITE DRIVE SUITE 101 CRANBERRY, PA 16066 | AFLAC | $9 | $0 | $9 | 0.17% |
| RITA BERGSTEIN BENEFITS LLC3 | 12260 STATE ROUTE 30 N HUNTIGNDON, PA 15642 | AFLAC | $5 | $0 | $5 | 0.10% |
| GAILE F DELBAUGH3 | PO BOC 83 MT. GRETNA, PA 17064 | AFLAC | $4 | $0 | $4 | 0.08% |
| DIANNE L MARTIN3 | 125 MANOR STREET HARRISBURG, PA 17110 | AFLAC | $3 | $0 | $3 | 0.06% |
| TERESA L FOUTZ3 | 1877 LEALAND AVE POLAND, OH 44514 | AFLAC | $1 | $0 | $1 | 0.02% |
| MARK D BARBIER3 | 802 DEER TRAIL LANE OAK BROOK, IL 60523 | AFLAC | $1 | $0 | $1 | 0.02% |
| TERESA L FOUTZ3 | 120 MARGUERITE DR SUITE 100 CRANBERRY TOWNSHIP, PA 16066 | AFLAC | $1 | $0 | $1 | 0.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AMERIFLEX, LLC ADMIN | Claims processing Service code 12 | 7 CARNEGIE PLAZA, SUITE 200 CHERRY HILL, NJ 08003 | $14K |
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 | 475 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 478 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTHAMERICA OF PENNYSLVANIA, INC. | 747 | $122K |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 224 | $92K |
| Vision | VISION BENEFITS OF AMERICA | 363 | $49K |
| Life insurance(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 475 | $199K |
| Short-term disability | AFLAC | 12 | $5K |
| Long-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 475 | $185K |
| Prescription drug | HEALTHAMERICA OF PENNYSLVANIA, INC. | 747 | $122K |
| Stop-loss / reinsurancereinsurance | HEALTHAMERICA OF PENNYSLVANIA, INC. | 747 | $122K |
| Other(4 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 475 | $125K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 747 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.