| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KISH BANK3 Filed as: KISH BENEFITS CONSULTING | 25 GATEWAY DR REEDSVILLE, PA 17044 | DOMINION NATIONAL | $921 | $0 | $921 | 9.90% |
| EMERSON REID LLC3 Filed as: EMERSON REID & COMPANY | 1305 WALT WHITMAN RD MELVILLE, NY 11747 | DOMINION NATIONAL | $460 | $0 | $460 | 4.95% |
| KISH BANK3 | 10 N DORCAS ST LEWISTOWN, PA 17044 | COMPANION LIFE | $1K | $0 | $1K | 16.14% |
| DEPROSPO INSURANCE3 | 1525 CEDAR CLIFF DR STE 102 CAMP HILL, PA 17011 | COMPANION LIFE | $671 | $0 | $671 | 8.07% |
| KISH BANK3 | 25 GATEWAY DR REEDSVILLE, PA 17084 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $447 | $0 | $447 | 5.82% |
| JENNIFER DEPROSPO3 | 750 LAKE DR LEBANON, PA 17042 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $342 | $0 | $342 | 4.45% |
| COLLETTE R CROYLE3 | 25 GATEWAY DR REIDSVILLE, PA 17084 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $68 | $0 | $68 | 0.89% |
| CHRISTOPHER CROYLE3 | 431 SUMMIT DR LEWISTOWN, PA 17044 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $42 | $0 | $42 | 0.55% |
| DEPROSO INS CONSULTING LLC3 | 750 LAKE DR LEBANON, PA 17042 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $28 | $0 | $28 | 0.36% |
| GRENINGER JR3 Filed as: GRENINGER JR SAMUEL CLAIR | 1484 GERMAN RD LOCK HAVEN, PA 17745 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4 | $0 | $4 | 0.05% |
| R & B INSURANCE SERVICES LLC3 | 209 WOODWARD AVE LOCK HAVEN, PA 17745 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3 | $0 | $3 | 0.04% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 1787 SENTRY PKWY, W BLUE BELL, PA 17422 | VISION BENEFITS OF AMERICA | $418 | $0 | $418 | 10.01% |
| KISH BANK3 | 25 GATEWAY DR REEDSVILLE, PA 17084 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $275 | $0 | $275 | 9.29% |
| CHRISTOPHER CROYLE3 | 431 SUMMIT DR LEWISTOWN, PA 17044 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $84 | $0 | $84 | 2.84% |
| KISH BANK3 | 25 GATEWAY DR REEDSVILLE, PA 17084 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $102 | $0 | $102 | 3.62% |
| CHRISTOPHER CROYLE3 | 431 SUMMIT DR LEWISTOWN, PA 17044 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $27 | $0 | $27 | 0.96% |
| JENNIFER DEPROSPO3 | 750 LAKE DR STE 102 LEBANON, PA 17042 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $218 | $0 | $218 | 10.05% |
| KISH BANK3 | 25 GATEWAY DR REEDSVILLE, PA 17084 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $171 | $0 | $171 | 7.88% |
| CHRISTOPHER CROYLE3 | 431 SUMMIT DR LEWISTOWN, PA 17044 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $29 | $0 | $29 | 1.34% |
| COLLETTE R CROYLE3 | 25 GATEWAY DR REIDSVILLE, PA 17084 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $19 | $0 | $19 | 0.88% |
| DEPROSPO INS CONSULTING LLC3 | 750 LAKE DR LEBANON, PA 17042 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $14 | $0 | $14 | 0.65% |
| JENNIFER DEPROSPO3 | 750 LAKE DR LEBANON, PA 17042 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $24 | $0 | $24 | 4.44% |
| KISH BANK3 | 25 GATEWAY DR REEDSVILLE, PA 17084 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $22 | $0 | $22 | 4.07% |
| COLLETTE R CROYLE3 | 25 GATEWAY DR REIDSVILLE, PA 17084 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $5 | $0 | $5 | 0.92% |
| DEPROSPO INS CONSULTING LLC3 | 750 LAKE DR LEBANON, PA 17042 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2 | $0 | $2 | 0.37% |
| KISH BANK3 | 25 GATEWAY DR REEDSVILLE, PA 17084 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $32 | $0 | $32 | 8.79% |
| CHRISTOPHER CROYLE3 | 431 SUMMIT DR LEWISTOWN, PA 17044 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $11 | $0 | $11 | 3.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MCGRIFF INSURANCE SERVICES EIN 56-1623293 BROKER | Insurance agents and brokers Service code 22 | — | $18K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $14K |
| CAPITAL BLUECROSS EIN 23-0455154 ADMIN | Claims processing Service code 12 | — | $8K |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $4K |
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 | 61 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 62 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DOMINION NATIONAL | 16 | $9K |
| Vision | VISION BENEFITS OF AMERICA | 39 | $4K |
| Life insurance(2 contracts) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 16 | $11K |
| Short-term disability | COMPANION LIFE | 15 | $8K |
| Stop-loss / reinsurancereinsurance | OPTUM HEALTH (UNIMERICA INSURANCE COMPANY) | 61 | $214K |
| Other(7 contracts, 2 carriers) | COMPANION LIFE | 16 | $25K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 61 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.