| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | FOUR RADNOR CORPORATE CENTER RADNOR, PA 19087 | INDEPENDENCE BLUE CROSS | $71K | $0 | $71K | 3.99% |
| MICHAEL R ACKERMAN3 Filed as: MICHAEL QUIA ONES ARENAS | UNKNOWN FORT WASHINGTON, PA 19034 | TRIPLE-S SALUD, INC. | $6K | $0 | $6K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITED CONCORDIA INSURANCE COMPANY | $6K | $0 | $6K | 6.15% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 2300 RENAISSANCE BOULEVARD KING OF PRUSSIA, PA 19406 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | $0 | $8K | 11.94% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $300 | $4K | 5.71% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, SUITE 1000 ROLLING MEADOWS, IL 60008 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.39% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4000 MIDLANTIC DRIVE, SUITE 350 MOUNT LAUREL, NJ 08054 | AETNA LIFE INSURANCE COMPANY | $450 | $0 | $450 | 2.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $878 | $0 | $878 | 4.96% |
| SVETLANA ZEITLIN3 | 105 ADDIS DRIVE CHURCHVILLE, PA 18966 | AFLAC | $695 | $36 | $731 | 4.13% |
| LUIS A. ALAMO COLON3 Filed as: LUIS ALAMO COLON | C19 CALLE 4 REPTO SAN JOSE REPARTO SAN JOSE GURABO, PR 00778 | AFLAC | $624 | $58 | $682 | 3.86% |
| ANDREW J JUNIKIEWICZ JR3 Filed as: ANDREW JUNKIKIEWICZ AND OTHER AGENT | 22 BROOK HOLLOW DRIVE SINKING SPRING, PA 19608 | AFLAC | $551 | $94 | $645 | 3.65% |
| MAYRA ADORNO SERRANO3 | HC 3 BOX 7572 DORADO, PR 00646 | AFLAC | $443 | $12 | $455 | 2.57% |
| RUSSELL L. DAYVAULT3 Filed as: RUSSELL DAYVAULT | 2777 MEADOWVIEW COURT TARPON SPRINGS, FL 34688 | AFLAC | $325 | $24 | $349 | 1.97% |
| MARIA IRIZARRY GARCIA3 | 151 CALLE FEDERICO COSTAS INDUSTRIAL TRES MONJITAS SUITE 5 SAN JUAN, PR 00918 | AFLAC | $174 | $12 | $186 | 1.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | AFLAC | $36 | $0 | $36 | 4.40% |
| SHELLY J. CAMPO3 Filed as: SHELLY CAMPO | PO BOX 84 GREEN LANE, PA 18054 | AFLAC | $32 | $0 | $32 | 3.91% |
| JOSE A SCHIENEMAN3 Filed as: JOSE SCHIENEMAN | 4515 SOUTH MCCLINTOCK DRIVE SUITE 212 TEMP, AZ 85282 | AFLAC | $12 | $0 | $12 | 1.47% |
| SVETLANA ZEITLIN3 | 105 ADDIS DRIVE CHURCHVILLE, PA 18966 | AFLAC | $9 | $0 | $9 | 1.10% |
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 | 144 | 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) | 144 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | INDEPENDENCE BLUE CROSS | 190 | $1.9M |
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 223 | $90K |
| Vision(2 contracts, 2 carriers) | INDEPENDENCE BLUE CROSS | 190 | $1.8M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 144 | $66K |
| Short-term disability | AFLAC | 27 | $18K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 144 | $66K |
| Prescription drug(2 contracts, 2 carriers) | INDEPENDENCE BLUE CROSS | 190 | $1.9M |
| Other(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 144 | $84K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 223 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.