| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ENGLE-HAMBRIGHT & DAVIES, INC. Filed as: ENGLE, HAMBRIGHT & DAVIES | 1857 WILLIAM PENN WAY PO BOX 11600 LANCASTER, PA 17605 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $42K | — | $42K | 4.18% |
| ENGLE-HAMBRIGHT & DAVIES, INC. Filed as: ENGLE, HAMBRIGHT, & DAVIES | 1857 WILLIAM PENN WAY PO BOX 11600 LANCASTER, PA 17605 | CAPITAL ADVANTAGE ASSURANCE COMPANY | — | — | $0 | 0.00% |
| PCI INSURANCE AGENCY3 Filed as: PCI INSURANCE, INC. | 417 WALNUT ST HARRISBURG, PA 17101 | UNITED CONCORDIA COMPANIES INC | — | — | $0 | 0.00% |
| J D LUEDTKE INC3 Filed as: JD LUEDTKE INC | 313 4TH ST HANOVER, PA 17331 | AFLAC | $785 | $14 | $799 | 3.60% |
| ROBERT W RICHARDSON3 Filed as: ROBERT RICHARDSON | 1860 HUNTERS FORK RD BELINGTON, WV 26250 | AFLAC | $597 | — | $597 | 2.69% |
| RANDALL D NAFTAL3 Filed as: RANDALL NAFTAL | 37 NORTH VALLEY RD 2 STATION SQUARE SUITE 201 PAOLI, PA 19301 | AFLAC | $521 | — | $521 | 2.35% |
| ENGLE-HAMBRIGHT & DAVIES, INC. Filed as: ENGLE-HAMBRIGHT & DAVIES INC | 115 E KING ST SUITE 2 LANCASTER, PA 17602 | AFLAC | $500 | — | $500 | 2.26% |
| CHERYL OARE3 | 640 ROYAL VIEW DR LANCASTER, PA 17601 | AFLAC | $339 | — | $339 | 1.53% |
| GERALD L WALSH3 Filed as: GERALD WALSH | 39 POCAHONTAS LANE HALIFAX, PA 17032 | AFLAC | $237 | — | $237 | 1.07% |
| ANTHONY S ALMODOVAR3 | 3605 VARTAN WAY SUITE 304 HARRISBURG, PA 17110 | AFLAC | $208 | $14 | $222 | 1.00% |
| ROBERT WERTZ3 Filed as: ROBERT W SCHARADIN JR | 1919 MAPLEWOOD DR CARLISLE, PA 17013 | AFLAC | $106 | $70 | $176 | 0.79% |
| ELAINE S AIKEN3 | 2202 FISHING CREEK RD WRIGHTSVILLE, PA 17368 | AFLAC | $87 | — | $87 | 0.39% |
| MICHAEL P NORRIS3 | 200 DALLAM RD NEWARK, DE 19711 | AFLAC | $66 | — | $66 | 0.30% |
| DIANNE L MARTIN3 | 125 MANOR STREET HARRISBURG, PA 17110 | AFLAC | $25 | — | $25 | 0.11% |
| ANTHONY S ALMODOVAR3 | 2405 PARK DR SUITE 101 HARRISBURG, PA 17110 | AFLAC | $24 | — | $24 | 0.11% |
| MATTHEW G BERGER3 | 22 SUNNYRIDGE RD PHILADELPHIA, PA 19125 | AFLAC | $22 | — | $22 | 0.10% |
| MARK D BARBIER3 Filed as: MARK BARBIER | 802 DEER TRAIL LN OAK BROOK, IL 60523 | AFLAC | $14 | — | $14 | 0.06% |
| KENNETH WEAVER3 | 433 S KINZER AVE 559VSA NEW HOLLAND, PA 17557 | AFLAC | $11 | — | $11 | 0.05% |
| HARRY D WAGNER3 | PO BOX 7247 AUDUBON, PA 19407 | AFLAC | $3 | — | $3 | 0.01% |
| LARRY L NEWMAN3 | PO BOX 785 SUNBURY, PA 17801 | AFLAC | $3 | — | $3 | 0.01% |
| MG BERGER INC3 | 1020 N DELAWARE AVE, SUITE 4 PHILADELPHIA, PA 19125 | AFLAC | $2 | — | $2 | 0.01% |
| IRENE E BROOKS | 833 NORTH PARK RD SUITE 220 READING, PA 19610 | AFLAC | $1 | — | $1 | 0.00% |
| DARREN D RIDDLE | 7850 AVONDALE TER HARRISBURG, PA 17112 | AFLAC | $1 | — | $1 | 0.00% |
| CHRISTOPHER A LUPP | 441 FRIENDSHIP RD SUITE 102 HARRISBURG, PA 17111 | AFLAC | $1 | — | $1 | 0.00% |
| RYAN K GOLDBERG | 103 CHURCH ST 3 PHILADELPHIA, PA 19106 | AFLAC | $1 | — | $1 | 0.00% |
| ANGELA MASSARELLI | 30 WATERFRON WAY HAMMONTON, NJ 08037 | AFLAC | — | — | $0 | 0.00% |
| MARTIN E BYSTROM | 333 OVERLOOK LN GULPH MILLS, PA 19428 | AFLAC | — | — | $0 | 0.00% |
| PCI INSURANCE AGENCY3 Filed as: PCI INSURANCE, INC. | 417 WALNUT ST HARRISBURG, PA 17101 | GUARDIAN LIFE | — | — | $0 | 0.00% |
| DAVID PEISCHL3 Filed as: DAVID P LILLY | — | SUN LIFE AND HEALTH INSURANCE COMPANY | $699 | — | $699 | 7.06% |
| PCI INSURANCE AGENCY3 Filed as: PCI INSURANCE, INC. | 417 WALNUT ST HARRISBURG, PA 17101 | DAVIS VISION | — | — | $0 | 0.00% |
| PINNACLE BROKERS Filed as: PINNACLE FINL SERVICES LLC | 4848 THOMPSON PKWY SUITE 200 JOHNSTOWN, CO 80435 | ALLSTATE | $166 | — | $166 | 6.20% |
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 | 181 | 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) | 181 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | CAPITAL ADVANTAGE ASSURANCE COMPANY | 132 | $1.1M |
| Dental | UNITED CONCORDIA COMPANIES INC | 91 | $36K |
| Vision | DAVIS VISION | 73 | $7K |
| Life insurance(2 contracts, 2 carriers) | GUARDIAN LIFE | 150 | $20K |
| Short-term disability | GUARDIAN LIFE | 150 | $10K |
| Long-term disability | GUARDIAN LIFE | 150 | $10K |
| Prescription drug | CAPITAL ADVANTAGE ASSURANCE COMPANY | 99 | $109K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 150 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.