| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | PO BOX 601478 CHARLOTTE, NC 282601478 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $17K | $0 | $17K | 6.68% |
| HARVARD PRINTING GROUP5 | 175 US HIGHWAY 46 WEST FAIRFIELD, NJ 070042327 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $617 | $617 | 0.24% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $273 | $273 | 0.11% |
| RIGGS COUNSELMAN MICHAELS & DOWNES3 Filed as: RIGGS, COUNSELMAN, MICHAELS & | DOWNES INC. 555 FAIRMONT AVENUE BALTIMORE, MD 21286 | ACE AMERICAN INSURANCE COMPANY | $10K | $0 | $10K | 16.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | $4K | $247 | $4K | 15.94% |
| J D LUEDTYKE, INC.3 | 313 FOURTH STREET HANOVER, PA 17331 | CONTINENTAL AMERICAN INSURANCE COMPANY | $867 | $0 | $867 | 4.27% |
| C H ROBINSON & ASSOCIATES INC3 Filed as: C H ROBINSON & ASSOCIATES INC. | 101 SE 2ND PLACE SUITE 201A GAINESVILLE, FL 32606 | CONTINENTAL AMERICAN INSURANCE COMPANY | $669 | $0 | $669 | 3.29% |
| ANTHONY S ALMODOVAR3 Filed as: ANTHONY S ALDMODOVAR | 2405 PARK DRIVE SUITE 101 HARRISBURG, PA 17110 | CONTINENTAL AMERICAN INSURANCE COMPANY | $285 | $0 | $285 | 1.40% |
| MG BERGER INC3 | 1020 NORTH DELAWARE AVENUE 4TH FLOOR PHILADELPHIA, PA 19125 | CONTINENTAL AMERICAN INSURANCE COMPANY | $141 | $0 | $141 | 0.69% |
| RYAN K GOLDBERG3 | POST OFFICE BOX 427 COLUMBIA, SC 29202 | CONTINENTAL AMERICAN INSURANCE COMPANY | $18 | $0 | $18 | 0.09% |
| DARREN D RIDDLE3 | 7850 AVONDALE TERRACE HARRISBURG, PA 17112 | CONTINENTAL AMERICAN INSURANCE COMPANY | $17 | $0 | $17 | 0.08% |
| ANGELA MASSARELLI3 | 432 TUVIRA LANE CHERRY HILL, NJ 08003 | CONTINENTAL AMERICAN INSURANCE COMPANY | $17 | $0 | $17 | 0.08% |
| MARTIN E SYSTROM3 | 333 OVERLOOK LANE GULPH MILLS, PA 19426 | CONTINENTAL AMERICAN INSURANCE COMPANY | $16 | $0 | $16 | 0.08% |
| RIGGS COUNSELMAN MICHAELS & DOWNES3 Filed as: RIGGS COUNSELMAN MICHAELS & D | 555 FAIRMOUNT AVENUE BALTIMORE, MD 21286 | HARTFORD LIFE AND ACCIDENT | $204 | $0 | $204 | 15.03% |
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 | 834 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 32 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 866 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY | 1,283 | $389K |
| Vision(2 contracts) | VISION BENEFITS OF AMERICA | 559 | $79K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 835 | $258K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 835 | $258K |
| Other(5 contracts, 4 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 835 | $370K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,283 | — |
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.