| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 1205 WESTLAKES DRIVE BERWYN, PA 19312 | INDEPENDENCE BLUE CROSS | $118K | — | $118K | 4.64% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | UNITED CONCORDIA INSURANCE COMPANY | $8K | — | $8K | 6.49% |
| MICHAEL R ACKERMAN3 Filed as: MICHAEL QUINONES ARENAS | UNKNOWN FORT WASHINGTON, PA 19034 | TRIPLE S SALUD, INC. | $5K | — | $5K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $980 | $7K | 11.66% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | VISION SERVICE PLAN | $1K | — | $1K | 4.78% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | AETNA LIFE INSURANCE COMPANY | $340 | $0 | $340 | 1.97% |
| DARLENE S DILLON3 Filed as: DARLENE S. DILLON | 120 WOODSIDE ROAD LEXINGTON, SC 29072 | AFLAC | $697 | $0 | $697 | 7.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $310 | $0 | $310 | 3.32% |
| SVETLANA ZEITLIN3 | 105 ADDIS DRIVE CHURCHVILLE, PA 18966 | AFLAC | $279 | $0 | $279 | 2.99% |
| MAYRA ADORNO SERRANO & OTHERS3 | 151 CALLE FEDERICO COSTAS INDUSTRIAL 3 MONJITAS, SUITE 5 SAN JUAN, PR 00918 | AFLAC | $115 | $0 | $115 | 1.23% |
| ANDREW J JUNIKIEWICZ JR3 | 22 BROOK HOLLOW DRIVE SINKING SPRING, PA 19608 | AFLAC | $105 | $0 | $105 | 1.12% |
| MATTHEW T O'HANLON3 Filed as: MATTHEW T O HANLON | 529 FAYETTE STREET, SUITE 202 STE 202 CONSHOHOCKEN, PA 19428 | AFLAC | $75 | $0 | $75 | 0.80% |
| JOSE A. SCHIEME,AM3 | 1881 SOUTH CARRIAGE LANE CHANDLER, AZ 85286 | AFLAC | $56 | $0 | $56 | 0.60% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $36 | $0 | $36 | 1.17% |
| SHELLY J. CAMPO3 | PO BOX 84 GREEN LANE, PA 18054 | AFLAC | $32 | $0 | $32 | 1.04% |
| JOSE A SCHIENEMAN3 Filed as: JOSE A. SCHIENEMAN | 1881 SOUTH CARRIAGE LANE CHANDLER, AZ 85286 | AFLAC | $12 | $0 | $12 | 0.39% |
| SVETLANA ZEITLIN3 | 105 ADDIS DRIVE CHURCHVILLE, PA 18966 | AFLAC | $9 | $0 | $9 | 0.29% |
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 | 181 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 181 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | INDEPENDENCE BLUE CROSS | 230 | $2.7M |
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 261 | $116K |
| Vision(3 contracts, 2 carriers) | INDEPENDENCE BLUE CROSS | 230 | $2.6M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 181 | $60K |
| Short-term disability | AFLAC | 10 | $9K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 181 | $60K |
| Prescription drug(3 contracts, 3 carriers) | INDEPENDENCE BLUE CROSS | 230 | $2.7M |
| Other(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 181 | $73K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 261 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.