| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 110 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $103 | $103 | 0.06% |
| STEPHEN BRETZ3 | 7950 TANGLEWOOD DRIVE NEW PORT RICHEY, FL 34654 | AFLAC | $226 | $0 | $226 | 2.13% |
| EDWARD F MROWKA JR3 Filed as: EDWARD MROWKA JR | 5106 TIMBER LANE SCHNECKSVILLE, PA 18078 | AFLAC | $209 | $0 | $209 | 1.97% |
| JANE N ARTMAN3 Filed as: JANE ARTMAN | 75 ARTMAN AVE HELLAM, PA 17406 | AFLAC | $170 | $0 | $170 | 1.61% |
| TODD E SHENBERGER3 Filed as: TODD SHENBERGER | 3620 WYOMING BLVD NE SUITE 102G ALBUGUERQUE, NM 87111 | AFLAC | $108 | $0 | $108 | 1.02% |
| JAMES A RUSH3 Filed as: JAMES RUSH | 1822 FAIRVIEW AVE EASTON, PA 18042 | AFLAC | $105 | $0 | $105 | 0.99% |
| BARRY E DRASHER3 | 320 LEHIGH ST WHITE HAVEN, PA 18661 | AFLAC | $78 | $0 | $78 | 0.74% |
| JACQUELINE EBERZ3 | 4949 LIBERTY LN STE 310 ALLENTOWN, PA 18106 | AFLAC | $56 | $0 | $56 | 0.53% |
| LISA A PERRI3 Filed as: LISA PERRY | 1650 SAND LAKE ROAD SUITE 201D ORLANDO, FL 32809 | AFLAC | $54 | $0 | $54 | 0.51% |
| JOSEPH FACCHIANO3 Filed as: JOSEPH DEGEORGE | 2740 ELM CT ALLENTOWN, PA 18104 | AFLAC | $54 | $0 | $54 | 0.51% |
| MARILYN BRANNEN3 | 3605 VARTAN WAY STE 304 HARRISBURG, PA 17110 | AFLAC | $53 | $0 | $53 | 0.50% |
| WILSON H TRANSUE3 Filed as: WILSON TRANSUE | 1487 SULLIVAN TRL TANNERSVILLE, PA 18372 | AFLAC | $50 | $0 | $50 | 0.47% |
| LARRY MYERS3 | 8944 N TRAVIS DR CITRUS SPRINGS, FL 34434 | AFLAC | $31 | $0 | $31 | 0.29% |
| WILLIAM M KNOTT3 Filed as: WILLIAM KNOTT | 24040 GREEN GARDENS CT EUSTIS, FL 32736 | AFLAC | $31 | $0 | $31 | 0.29% |
| JASON E FERGER3 Filed as: JASON FERGER | 3706 EAGLEWOOD ST VALRICO, FL 33596 | AFLAC | $28 | $0 | $28 | 0.26% |
| DONALD GREEN3 | 1611 W PLACITA GARBO GREEN VALLEY, AZ 85622 | AFLAC | $24 | $0 | $24 | 0.23% |
| FAITH CRYSTAL TAYLOR3 Filed as: FAITH BURRIS | 251 LONG BEACH DR HOT SPRINGS, AR 71913 | AFLAC | $20 | $0 | $20 | 0.19% |
| RPM LTD3 | 25 WEATHERBY CIR SAVANNAH, GA 31405 | AFLAC | $19 | $0 | $19 | 0.18% |
| CAROL A MROWKA3 Filed as: CAROL MROWKA | 5106 TIMBER LANE SCHNECKSVILLE, PA 18078 | AFLAC | $17 | $0 | $17 | 0.16% |
| RANDALL SIMS3 | 138 DERR DR COLLEGEVILLE, PA 19426 | AFLAC | $14 | $0 | $14 | 0.13% |
| JAMES BROOKS3 | 1253 WEST LEESPORT ROAD LEESPORT, PA 19533 | AFLAC | $12 | $0 | $12 | 0.11% |
| KYMBERLY G KNOTT3 Filed as: KYMBERLY KNOTT | 24040 GREEN GARDENS CT EUSTIS, FL 32736 | AFLAC | $12 | $0 | $12 | 0.11% |
| DIANNE L MARTIN3 Filed as: DIANNE MARTIN | 125 MANOR STREET HARRISBURG, PA 17110 | AFLAC | $9 | $0 | $9 | 0.09% |
| JOHN B LACARIA3 Filed as: JOHN LACARIA | 102 JENNIFER LN BRIDGEPORT, WV 26330 | AFLAC | $8 | $0 | $8 | 0.08% |
| MARY ELLEN BELL GRETH3 Filed as: MARY ELLEN GRETH | 1807 READING BLVD WYOMISSING, PA 19610 | AFLAC | $5 | $0 | $5 | 0.05% |
| DANIEL R JUDY3 Filed as: DANIEL JUDY | 231 WALTERS MILL RD SOMERSET, PA 15501 | AFLAC | $2 | $0 | $2 | 0.02% |
| RYAN GOLDBERG3 | 103 CHURCH ST #3 PHILADELPHIA, PA 19106 | AFLAC | $2 | $0 | $2 | 0.02% |
| DARREN RIDDLE3 | 7850 AVONDALE TER HARRISBURG, PA 17112 | AFLAC | $2 | $0 | $2 | 0.02% |
| ANGELA MASSARELLI3 | 30 WATERFRONT WAY HAMMONTON, NJ 08037 | AFLAC | $1 | $0 | $1 | 0.01% |
| MARK D BARBIER3 Filed as: MARK BARBIER | 802 DEER TRAIL LN OAK BROOK, IL 60523 | AFLAC | $1 | $0 | $1 | 0.01% |
| IRENE E BROOKS3 Filed as: IRENE BROOKS | 833 NORTH PARK ROAD SUITE 220 READING, PA 19610 | AFLAC | $1 | $0 | $1 | 0.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH AMERICA EIN 62-1411933 ADMIN | Claims processing Service code 12 | — | $115K |
| MCCONKEY BENEFITS & FINANCIAL SERV EIN 23-3086396 BROKER | Insurance agents and brokers Service code 22 | — | $66K |
| DELTA DENTAL OF PENNSYLVANIA EIN 23-1667011 ADMIN | Claims processing Service code 12 | — | $24K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $23K |
| BENEFITMALL ADMIN | Claims processing Service code 12 | 501 FAIRMONT AVENUE SUITE 400 TOWSON, MD 21286 | $14K |
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 | 283 | 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) | 283 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | NATIONAL VISION ADMINISTRATORS - HEARTLAND | 493 | $20K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 283 | $169K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 283 | $169K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 283 | $169K |
| Other(4 contracts, 4 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 283 | $184K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 493 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.