| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 4000 MIDLANTIC DRIVE, SUITE 300 MOUNT LAUREL, NJ 08054 | INDEPENDENCE BLUE CROSS | $71K | $6K | $77K | 4.33% |
| MICHAEL R ACKERMAN3 Filed as: MICHAEL QUINONES ARENAS | UNKNOWN FORT WASHINGTON, PA 19034 | TRIPLE S SALUD, INC. | $3K | $0 | $3K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $0 | $6K | 11.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.80% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4000 MIDLANTIC DRIVE, SUITE 300 MOUNT LAUREL, NJ 08054 | AETNA LIFE INSURANCE COMPANY | $0 | $510 | $510 | 3.06% |
| SVETLANA ZEITLIN3 | 105 ADDIS DRIVE CHURCHVILLE, PA 18966 | AFLAC | $863 | $19 | $882 | 8.22% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $791 | $0 | $791 | 7.37% |
| LAUNCHPAD BENEFITS SOLUTIONS LLC3 Filed as: LAUNCHPAD BENEFITS SOLUTIONS, LLC | 529 FAYETTE STREET, SUITE 202 CONSHOHOCKEN, PA 19428 | AFLAC | $148 | $4 | $152 | 1.42% |
| MAYRA ADORNO SERRANO3 | 151 CALLE FEDERICO COSTAS INDUSTRIAL 3 MONJITAS, SUITE 5 SUAN JUAN, PR 00918 | AFLAC | $65 | $0 | $65 | 0.61% |
| RUSSEL L. DAYVAULT AND OTHER AGENTS3 | 2777 MEADOWVIEW COURT TARPON SPRINGS, FL 34688 | AFLAC | $57 | $0 | $57 | 0.53% |
| JOSE A SCHIENEMAN3 Filed as: JOSE A. SCHIENEMAN | 1881 SOUTH CARRIAGE LANE CHANDLER, AZ 85286 | AFLAC | $55 | $0 | $55 | 0.51% |
| ANDREW J JUNIKIEWICZ JR3 Filed as: ANDREW J. JUNIKIEWICZ, JR. | 22 BROOK HOLLOW DRIVE SINKING SPRING, PA 19608 | AFLAC | $48 | $0 | $48 | 0.45% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $24 | $0 | $24 | 1.15% |
| SHELLY J. CAMPO3 | PO BOX 84 GREEN LANE, PA 18054 | AFLAC | $21 | $0 | $21 | 1.01% |
| JOSE A SCHIENEMAN3 Filed as: JOSE A. SCHIENEMAN | 1881 SOUTH CARRIAGE LANE CHANDLER, AZ 85286 | AFLAC | $8 | $0 | $8 | 0.38% |
| SVETLANA ZEITLIN3 | 105 ADDIS DRIVE CHURCHVILLE, PA 18966 | AFLAC | $6 | $0 | $6 | 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 | 169 | 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) | 169 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | INDEPENDENCE BLUE CROSS | 228 | $1.9M |
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 266 | $108K |
| Vision(2 contracts, 2 carriers) | INDEPENDENCE BLUE CROSS | 228 | $1.8M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 169 | $57K |
| Short-term disability | AFLAC | 13 | $11K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 169 | $57K |
| Prescription drug(3 contracts, 3 carriers) | INDEPENDENCE BLUE CROSS | 228 | $1.9M |
| Other(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 169 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 266 | — |
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.