| 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 | $71K | — | $71K | 7.99% |
| PFB MEMBER SERVICE CORP | 510 SOUTH 31ST STREET CAMP HILL, PA 17011 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $7K | — | $7K | 1.92% |
| PFB MEMBER SERVICE CORP | 510 SOUTH 31ST STREET CAMP HILL, PA 17011 | METROPOLITAN 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 | $3K | $1K | $4K | 18.72% |
| CAROLINE ANGELINE MCCHESNEY | 131 GREEN THUMB RD BLAIRSVILLE, PA 15717 | AFLAC | $313 | — | $313 | 11.38% |
| MATTHEW G BURNSIDE | 13309 CANTERBURY CASTLE DR CHARLOTTE, NC 28273 | AFLAC | $99 | — | $99 | 3.60% |
| KHS BENEFITS LLC | 19 PHYLLIS DR IMPERIAL, PA 15126 | AFLAC | $64 | — | $64 | 2.33% |
| VICKI J VELTRI | 1175 BALKAN DR PITTSBURGH, PA 15239 | AFLAC | $51 | — | $51 | 1.85% |
| SMITH BENEFITS CONSULTING GROUP | 810 RIVER AVE STE 230 PITTSBURGH, PA 15212 | AFLAC | $41 | — | $41 | 1.49% |
| BRYAN FISH | 4050 CANDLE LIGHT DR DAYTON, MD 21036 | AFLAC | $22 | — | $22 | 0.80% |
| JAMES D MAXWELL | 804 AUDUBON CIR NORTH AUGUSTA, SC 29841 | AFLAC | $17 | — | $17 | 0.62% |
| JUSTIN MUDGETT | 2290 W VALLEY LN WESTMINSTER, MD 21158 | AFLAC | $16 | — | $16 | 0.58% |
| ROBERT WERTZ | PO BOX 961 CARLISLE, PA 17013 | AFLAC | $10 | — | $10 | 0.36% |
| ETHAN ROBERT RIFFE | 5500 BROOKTREE RD STE 102 WEXFORD, PA 15090 | AFLAC | $9 | — | $9 | 0.33% |
| JAMES C MAXWELL | 2010 BROOKS EDGE DR APT 107 CAMP HILL, PA 17011 | AFLAC | $6 | — | $6 | 0.22% |
| DAVID MORNINGSTAR | 4281 BUCKSKIN WOOD DR ELLICOTT CITY, MD 21042 | AFLAC | $3 | — | $3 | 0.11% |
| JEREMY A FELDMAN | 12391 HIDDEN BAY DR BERLIN, MD 21811 | AFLAC | $3 | — | $3 | 0.11% |
| DOMINICK J LACARIA | 216 ROSCOMMON PL MCMURRAY, PA 15317 | AFLAC | $2 | — | $2 | 0.07% |
| EDWIN VEGA | 8214 LEE AVE SEVERN, MD 21144 | AFLAC | $1 | — | $1 | 0.04% |
| KELLY LYNN FELDMAN | 12391 HIDDEN BAY DR BERLIN, MD 21811 | AFLAC | $1 | — | $1 | 0.04% |
| BRIAN W PATTEN | 120 MARGUERITE DR STE 101 CRANBERRY TOWNSHIP, PA 16066 | AFLAC | $1 | — | $1 | 0.04% |
| JOY GRUBE PADGELEK | 1195 WASHINGTON PIKE STE 300 BRIDGEVILLE, PA 15017 | AFLAC | $1 | — | $1 | 0.04% |
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 | 31 | Currently employed and enrolled or eligible. |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 34 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CAPITAL ADVANTAGE ASSURANCE COMPANY | 0 | $359K |
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 2,152 | $886K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 1,911 | $133K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 0 | $22K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 0 | $22K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 0 | $22K |
| Other | AFLAC | 3 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,152 | — |
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.