| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 1205 WESTLAKES DRIVE BERWYN, PA 19312 | INDEPENDENCE BLUE CROSS | $87K | $6K | $93K | 4.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | UNITED CONCORDIA INSURANCE COMPANY | $7K | — | $7K | 6.52% |
| MICHAEL R ACKERMAN3 Filed as: MICHAEL QUINONES ARENAS | UNKNOWN FORT WASHINGTON, PA 19034 | TRIPLE S SALUD, INC. | $4K | $0 | $4K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $793 | $7K | 11.22% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.00% |
| SVETLANA ZEITLIN3 | 105 ADDIS DRIVE CHURCHVILLE, PA 18966 | AFLAC | $445 | $39 | $484 | 5.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $447 | $0 | $447 | 4.89% |
| LAUNCHPAD BENEFITS SOLUTIONS LLC3 Filed as: LAUNCHPAD BENEFITS SOLUTIONS, LLC | 529 FAYETTE STREET, SUITE 202 CONSHOHOCKEN, PA 19428 | AFLAC | $52 | $9 | $61 | 0.67% |
| RUSSELL L. DAYVAULT3 Filed as: RUSSELL DAYVAULT AND OTHER AGENTS | 2777 MEADOWVIEW COURT TARPON SPRINGS, FL 34688 | AFLAC | $61 | $0 | $61 | 0.67% |
| JOSE A SCHIENEMAN3 Filed as: JOSE SCHIENEMAN | 1881 SOUTH CARRIAGE LANE CHANDLER, AZ 85286 | AFLAC | $57 | $0 | $57 | 0.62% |
| MAYRA ADORNO SERRANO3 | 151 CALLE FEDERICO COSTAS INDUSTRIAL3 MONJITAS, SUITE 5 SANJUAN, PR 00918 | AFLAC | $45 | $0 | $45 | 0.49% |
| ANDREW J JUNIKIEWICZ JR3 Filed as: ANDREW JUNIKIEWICZ JR | 22 BROOK HOLLOW DRIVE SINKING SPRING, PA 19608 | AFLAC | $42 | $0 | $42 | 0.46% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $50 | $0 | $50 | 1.26% |
| SHELLY J. CAMPO3 Filed as: SHELLY CAMPO | PO BOX 84 GREEN LANE, PA 18054 | AFLAC | $45 | $0 | $45 | 1.13% |
| JOSE A SCHIENEMAN3 Filed as: JOSE SCHIENEMAN | 1881 SOUTH CARRIAGE LANE CHANDLER, AZ 85286 | AFLAC | $17 | — | $17 | 0.43% |
| SVETLANA ZEITLIN3 | 105 ADDIS DRIVE CHURCHVILLE, PA 18966 | AFLAC | $13 | $0 | $13 | 0.33% |
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 | 186 | 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) | 186 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | INDEPENDENCE BLUE CROSS | 236 | $2.1M |
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 264 | $115K |
| Vision(2 contracts, 2 carriers) | INDEPENDENCE BLUE CROSS | 236 | $2.1M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 186 | $65K |
| Short-term disability | AFLAC | 10 | $9K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 186 | $65K |
| Prescription drug(3 contracts, 3 carriers) | INDEPENDENCE BLUE CROSS | 236 | $2.1M |
| Other(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 186 | $78K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 264 | — |
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.