| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PFB MEMBER SERVICE CORP | 510 SOUTH 31ST STREET CAMP HILL, PA 17011 | UNITED CONCORDIA INSURANCE COMPANY | $80K | — | $80K | 8.64% |
| PFB MEMBER SERVICE CORP | 510 SOUTH 31ST STREET CAMP HILL, PA 17011 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $14K | — | $14K | 2.47% |
| PFB MEMBER SERVICE CORP | 510 SOUTH 31ST STREET CAMP HILL, PA 17011 | HM LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $2K | $7K | 18.51% |
| MATTHEW G BURNSIDE | 13309 CANTERBURY CASTLE DR CHARLOTTE, NC 28273 | AFLAC | $91 | — | $91 | 4.81% |
| VICKI J VELTRI | 1175 BALKAN DR PITTSBURGH, PA 15239 | AFLAC | $48 | — | $48 | 2.54% |
| BRYAN FISH | 4050 CANDLE LIGHT DR DAYTON, MD 21036 | AFLAC | $21 | — | $21 | 1.11% |
| JAMES D MAXWELL | 804 AUDUBON CIR NORTH AUGUSTA, SC 29841 | AFLAC | $15 | — | $15 | 0.79% |
| JUSTIN MUDGETT | 2290 W VALLEY LN WESTMINSTER, MD 21158 | AFLAC | $15 | — | $15 | 0.79% |
| ETHAN ROBERT RIFFE | 5500 BROOKTREE RD STE 102 WEXFORD, PA 15090 | AFLAC | $9 | — | $9 | 0.48% |
| ROBERT WERTZ | PO BOX 961 CARLISLE, PA 17013 | AFLAC | $9 | — | $9 | 0.48% |
| JAMES C MAXWELL | 2010 BROOKS EDGE DR APT 107 CAMP HILL, PA 17011 | AFLAC | $6 | — | $6 | 0.32% |
| DAVID MORNINGSTAR | 4281 BUCKSKIN WOOD DR ELLICOTT CITY, MD 21042 | AFLAC | $3 | — | $3 | 0.16% |
| JEREMY A FELDMAN | 12391 HIDDEN BAY DR BERLIN, MD 21811 | AFLAC | $2 | — | $2 | 0.11% |
| DOMINICK J LACARIA | 216 ROSCOMMON PL MCMURRAY, PA 15317 | AFLAC | $2 | — | $2 | 0.11% |
| EDWIN VEGA | 8214 LEE AVE SEVERN, MD 21144 | AFLAC | $1 | — | $1 | 0.05% |
| KELLY LYNN FELDMAN | 12391 HIDDEN BAY DR BERLIN, MD 21811 | AFLAC | $1 | — | $1 | 0.05% |
| BRIAN W PATTEN | 120 MARGUERITE DR STE 101 CRANBERRY TOWNSHIP, PA 16066 | AFLAC | $1 | — | $1 | 0.05% |
| JOY GRUBE PADGELEK | 1195 WASHINGTON PIKE STE 300 BRIDGEVILLE, PA 15017 | AFLAC | $1 | — | $1 | 0.05% |
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 | 48 | Currently employed and enrolled or eligible. |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 51 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CAPITAL ADVANTAGE ASSURANCE COMPANY | 0 | $567K |
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 2,252 | $931K |
| Vision | HM LIFE INSURANCE COMPANY | 1,979 | $140K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 0 | $39K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 0 | $39K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 0 | $39K |
| Other | AFLAC | 2 | $2K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,252 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.