| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCCONKEY BENEFITS & FINANCIAL SERV3 | 2555 KINGSTON ROAD SUITE 100 YORK, PA 17402 | DELTA DENTAL OF PENNSYLVANIA | $7K | $0 | $7K | 5.00% |
| JENNIFER DEPROSPO3 | 750 LAKE DRIVE LEBANON, PA 17042 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | $0 | $2K | 1.81% |
| RJM ASSOCIATES INC DBA RM ASSOCIATE3 Filed as: RJM ASSOCIATES DBA RM ASSOCIATES | PO BOX 5841 WILMINGTON, DE 19808 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $346 | $0 | $346 | 0.41% |
| IRENE E BROOKS3 | 1253 WEST LEESPORT ROAD LEESPORT, PA 19533 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $266 | $0 | $266 | 0.32% |
| ALLEN MARK BRITTELL3 | 1949 SECURITY DRIVE YORK, PA 17402 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $228 | $0 | $228 | 0.27% |
| GEORGE A TROCKI3 Filed as: GEORGE TROCKI | 221 PROSPECT CIRCLE SHREWSBURY, PA 17361 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $162 | $0 | $162 | 0.19% |
| MICHAEL R MUMMERT3 | 2116 S QUEEN ST YORK, PA 17403 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $43 | $0 | $43 | 0.05% |
| JAMES H CROUTHAMEL3 Filed as: JAMES H CROTHAMEL | PO BOX 1148 SOUTHAMPTON, PA 18966 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $37 | $0 | $37 | 0.04% |
| M THERESA CONWAY3 Filed as: THERESA M CONWAY | PO BOX 44 HUMMELSTOWN, PA 17036 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $8 | $0 | $8 | 0.01% |
| MCCONKEY BENEFITS & FINANCIAL SERV3 | 2555 KINGSTON ROAD SUITE 100 YORK, PA 17402 | VISION BENEFITS OF AMERICA | $1K | $0 | $1K | 4.79% |
| LAYNE FINANCIAL INC3 | 315 GREEN RIDGE RD H-1 NEW CASTLE, PA 16105 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 53.77% |
| MCCONKEY BENEFITS & FINANCIAL SERV3 | 2555 KINGSTON RD SUITE 100 YORK, PA 17402 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 46.23% |
| M THERESA CONWAY3 Filed as: THERESA M CONWAY | PO BOX 44 HUMMELSTOWN, PA 17036 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $82 | $0 | $82 | 1.60% |
| ALLEN MARK BRITTELL3 | 1949 SECURITY DRIVE YORK, PA 17402 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $54 | $0 | $54 | 1.06% |
| RJM ASSOCIATES INC DBA RM ASSOCIATE3 | PO BOX 5841 WILMINGTON, DE 19808 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $49 | $0 | $49 | 0.96% |
| MICHAEL R MUMMERT3 | 2116 S QUEEN ST YORK, PA 17403 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $11 | $0 | $11 | 0.22% |
| GEORGE A TROCKI3 Filed as: GEORGE TROCKI | 221 PROSPECT CIRCLE SHREWSBURY, PA 17361 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $11 | $0 | $11 | 0.22% |
| JAMES H CROUTHAMEL3 | PO BOX 1148 SOUTHAMPTON, PA 18966 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $8 | $0 | $8 | 0.16% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAPITAL ADVANTAGE ASSURANCE COMPANY EIN 45-5492167 ADMIN | Claims processing Service code 12 | — | $113K |
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 | 252 | 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) | 252 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 162 | $84K |
| Dental | DELTA DENTAL OF PENNSYLVANIA | 502 | $136K |
| Vision | VISION BENEFITS OF AMERICA | 245 | $25K |
| Life insurance | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 162 | $84K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 252 | $12K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 252 | $12K |
| Stop-loss / reinsurancereinsurance | AVALON INSURANCE COMPANY | 229 | $323K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 252 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 502 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.