| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LAYNE FINANCIAL INC3 | 315 GREEN RIDGE SR, STE H1 NEW CASTLE, PA 16015 | AMERICA UNITED LIFE INSURANCE COMPANY | $11K | $5K | $16K | 16.94% |
| MURRAY INSURANCE ASSOCIATES3 Filed as: MURRAY INSURANCE ASSOCIATES INC | 38 N DUKE ST LANCASTER, PA 17602 | UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY | $3K | — | $3K | 4.00% |
| SAMUEL ALBERT BOORE JR3 | 110 RODNEY LANE CAMP HILL, PA 17011 | AMERICAN HERITAGE LIFE | $205 | — | $205 | 4.49% |
| JENNIFER DEPROSPO3 | 750 LAKE DR LEBANON, PA 17042 | AMERICAN HERITAGE LIFE | $96 | — | $96 | 2.10% |
| LAYNE FINANCIAL INC3 | 315 GREEN RIDGE SR, STE H1 NEW CASTLE, PA 16015 | AMERICAN HERITAGE LIFE | $88 | — | $88 | 1.93% |
| JIM BROOKS3 | 1253 WEST LEESPORT RD LEESPORT, PA 19533 | AMERICAN HERITAGE LIFE | $38 | — | $38 | 0.83% |
| GAYLORD I KAUFFMAN3 Filed as: GAYLORD KAUFFMAN | 315 GREEN RIDGE SR, STE H1 NEW CASTLE, PA 16015 | AMERICAN HERITAGE LIFE | $14 | — | $14 | 0.31% |
| EVA M ALEXANDER3 Filed as: EVA ALEXANDER | 119 WINDING HILL DR LANCASTER, PA 17601 | AFLAC | $99 | — | $99 | 5.77% |
| D J STONE3 | 918 DARBY LANE LANCASTER, PA 17601 | AFLAC | $44 | — | $44 | 2.56% |
| JANE N ARTMAN3 | 75 ARTMAN AVE HELLAM, PA 17406 | AFLAC | $30 | — | $30 | 1.75% |
| DIANNE L MARTIN Filed as: DIANNE L. MARTIN | 125 MANOR STREET HARRISBURG, PA 17110 | AFLAC | $20 | — | $20 | 1.17% |
| RPM LTD3 | P O BOX 484 BLOOMINGDALE, GA 31302 | AFLAC | $14 | — | $14 | 0.82% |
| MELYNDA S HASSELBACH3 Filed as: MELYNDA S. HASSELBACH | 53 BLUE ROCK RD MILLERSVILLE, PA 17551 | AFLAC | $12 | — | $12 | 0.70% |
| ANTHONY S ALMODOVAR Filed as: ANTHONY S. ALMODOVAR | 2405 PARK DRIVE, STE 101 HARRISBURG, PA 17110 | AFLAC | $10 | — | $10 | 0.58% |
| RANDALL SIMS3 | 138 DERR DR COLLEGEVILLE, PA 19426 | AFLAC | $7 | — | $7 | 0.41% |
| DAVID W RANCK3 | P O BOX 277 EPHRATA, PA 17522 | AFLAC | $6 | — | $6 | 0.35% |
| SHELLY S GWIN3 | 94 OATFIELD DR DENVER, PA 17517 | AFLAC | $5 | — | $5 | 0.29% |
| DANIEL R JUDY3 | 231 WALTERS MILL RD SOMERSET, PA 15501 | AFLAC | $2 | — | $2 | 0.12% |
| MG BERGER INC | 1020 N DELAWARE AVE, STE 4 PHILADELPHIA, PA 19125 | AFLAC | $1 | — | $1 | 0.06% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HIGHMARK EIN 23-1294723 NONE | Insurance services; Contract Administrator Service code 13 | — | $82K |
| MURRAY INSURANCE ASSOCIATES INC NONE | Other fees; Insurance brokerage commissions and fees Service code 53 | 39 N DUKE ST LANCASTER, PA 17602 | $0 |
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 | 162 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 162 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AMERICAN HERITAGE LIFE | 10 | $5K |
| Dental | UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY | 231 | $73K |
| Vision | HIGHMARK | 203 | $13K |
| Life insurance | AMERICA UNITED LIFE INSURANCE COMPANY | 176 | $92K |
| Short-term disability(2 contracts, 2 carriers) | AMERICA UNITED LIFE INSURANCE COMPANY | 176 | $93K |
| Long-term disability | AMERICA UNITED LIFE INSURANCE COMPANY | 176 | $92K |
| Stop-loss / reinsurancereinsurance | HM INSURANCE COMPANY | 160 | $236K |
| Other(2 contracts, 2 carriers) | AMERICA UNITED LIFE INSURANCE COMPANY | 176 | $93K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 231 | — |
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.