| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CONSTANCE A TREIBLE3 | 128 WILLIAMS ROAD CRESCO, PA 18326 | AFLAC | $5K | $53 | $5K | 6.05% |
| STEPHEN D BISSELL3 Filed as: STEPHEN D. BISSELL | 5465 AMANDA DRIVE LAURYS STATION, PA 18059 | AFLAC | $5K | $22 | $5K | 5.44% |
| JEFFREY CHUBB3 | 520 W. 4TH ST. SUITE 1A WILLIAMSPORT, PA 17701 | AFLAC | $1K | $22 | $1K | 1.65% |
| TINA BONCHER3 Filed as: TINA M. BONCHER | 288 COLD SPRING DRIVE JIM THORPE, PA 18229 | AFLAC | $1K | — | $1K | 1.37% |
| JAMES ZARODA3 Filed as: JAMES B. ZARODA | 24 INDEPENDENCE ROAD MOUNTAIN TOP, PA 18707 | AFLAC | $1K | $3 | $1K | 1.18% |
| DAVID CALBY3 | 10 HINDS STREET MONTROSE, PA 18801 | AFLAC | $729 | — | $729 | 0.83% |
| DEBRA PIERCE3 Filed as: DEBRA J. PIERCE | 2108 CLOCUM ROAD MOUNTAIN TOP, PA 18707 | AFLAC | $376 | $14 | $390 | 0.44% |
| WILSON H TRANSUE3 Filed as: WILSON H. TRANSUE | 1487 SULLIVAN TRL TANNERSVILLE, PA 18372 | AFLAC | $327 | — | $327 | 0.37% |
| DOUGLAS R. BORLAND3 | 919 SCOTT STREET WILKES BARRE, PA 18705 | AFLAC | $234 | $36 | $270 | 0.31% |
| C A LUPP INC3 Filed as: C A LUPP, INC. | 441 FRIENDSHIP ROAD SUITE 102 HARRISBURG, PA 17111 | AFLAC | $170 | — | $170 | 0.19% |
| FRED A REEDER3 Filed as: FRED A. REEDER | 380 E. MAIN STREET LOCK HAVEN, PA 17745 | AFLAC | $168 | — | $168 | 0.19% |
| MATTHEW G BERGER3 Filed as: MATTHEW G. BERGER | 22 SUNNYRIDGE ROAD PHILADELPHIA, PA 19125 | AFLAC | $162 | — | $162 | 0.18% |
| JOSEPH G GRABLICK3 Filed as: JOSEPH G. GRABLICK | 716 SUSQUEHANNA AVE. WYOMING, PA 18644 | AFLAC | $140 | — | $140 | 0.16% |
| ALEXANDER BATISTA3 | 1 KINGS AVE. EASTON, PA 18045 | AFLAC | $105 | — | $105 | 0.12% |
| BLACK ROK BENEFIT ALLIANCE LLC3 Filed as: BLACK ROK BENEFIT ALLIANCE, LLC | PO BOX 211 YOUNGWOOD, PA 15697 | AFLAC | $95 | — | $95 | 0.11% |
| KEITH LOWTHERT3 | 1699 WYOMING AVE. FORTY FORT, PA 18704 | AFLAC | $84 | — | $84 | 0.10% |
| DAVID W RANCK3 Filed as: DAVID W. RANCK | PO BOX 277 EPHRATA, PA 17522 | AFLAC | $75 | — | $75 | 0.09% |
| JOSEPH F. SULLIVAN3 | 1058 COMMANCHE TRAIL GOULDSBORO, PA 18424 | AFLAC | $65 | — | $65 | 0.07% |
| DIANNE L MARTIN3 Filed as: DIANNE L. MARTIN | 125 MANOR STREET HARRISBURG, PA 17110 | AFLAC | $51 | — | $51 | 0.06% |
| SEAN T JUDGE3 Filed as: SEAN T. JUDGE | 95 POPLAR STREET KINGSTON, PA 18704 | AFLAC | $50 | — | $50 | 0.06% |
| KENT E FOSTER3 Filed as: KENT E. FOSTER | 3527 US HIGHWAY 52 DECORAH, IA 52101 | AFLAC | $44 | — | $44 | 0.05% |
| RANDALL SIMS3 | 138 DERR DRIVE COLLEGEVILLE, PA 19426 | AFLAC | $35 | — | $35 | 0.04% |
| JOHN M WASHO3 Filed as: JOHN M. WASHHO | 106 CEDAR BLUFF CT. ALEDO, TX 76008 | AFLAC | $33 | — | $33 | 0.04% |
| JOSEPH RYNCAVAGE3 | 140 MAIN STREET KINGSTON, PA 18704 | AFLAC | $32 | — | $32 | 0.04% |
| MARK D BARBIER3 Filed as: MARK D. BARBIER | 802 DEER TRAIL LANE OAK BROOK, IL 60523 | AFLAC | $27 | — | $27 | 0.03% |
| LISA A BROMAGE3 Filed as: LISA A. BROMAGE | 157 SPRING STREET SCRANTON, PA 18508 | AFLAC | $19 | — | $19 | 0.02% |
| MG BERGER INC3 Filed as: MG BERGER INC. | 1020 N. DELAWARE AVE. SUITE 4 PHILADELPHIA, PA 19125 | AFLAC | $18 | — | $18 | 0.02% |
| PETER R. TREIBLE3 | 128 WILLIAMS ROAD CRESCO, PA 18326 | AFLAC | $10 | — | $10 | 0.01% |
| DARREN D RIDDLE3 Filed as: DARREN D. RIDDLE | 7850 AVONDALE TER. HARRISBURG, PA 17112 | AFLAC | $8 | — | $8 | 0.01% |
| ANGELA MASSARELLI3 | 30 WATERFRONT WAY HAMMONTON, NJ 08037 | AFLAC | $5 | — | $5 | 0.01% |
| NORTH EAST EMPIRE INC3 Filed as: NORTH EAST EMPIRE, INC. | 93 WOODSIDE ROAD DANVILLE, PA 17821 | AFLAC | $4 | — | $4 | 0.00% |
| RYAN K GOLDBERG3 Filed as: RYAN K. GOLDBERG | 103 CHURCH ST. #3 PHILADELPHIA, PA 19106 | AFLAC | $4 | — | $4 | 0.00% |
| IRENE E BROOKS3 Filed as: IRENE E. BROOKS | 833 NORTH PARK ROAD SUITE 220 READING, PA 19610 | AFLAC | $4 | — | $4 | 0.00% |
| NORTH EAST EMPIRE INC3 Filed as: NORTH EAST EMPIRE, INC. | 8 W. BROAD ST. SUITE 720 HAZELTON, PA 18201 | AFLAC | $4 | — | $4 | 0.00% |
| WILLIAM M KNOTT3 Filed as: WILLIAM M. KNOTT | 24040 GREEN GARDENS CT. EUSTIS, FL 32736 | AFLAC | $4 | — | $4 | 0.00% |
| CHRISTOPHER A LUPP3 Filed as: CHRISTOPHER A. LUPP | 441 FRIENDSHIP RD. SUITE 102 HARRISBURG, PA 17111 | AFLAC | $3 | — | $3 | 0.00% |
| MARTIN E BYSTROM3 Filed as: MARTIN E. BYSTROM | 333 OVERLOOK LANE GULPH MILLS, PA 19428 | AFLAC | $3 | — | $3 | 0.00% |
| DANIEL R JUDY3 Filed as: DANIEL R. JUDY | 231 WALTERS MILL ROAD SOMERSET, PA 15501 | AFLAC | $2 | — | $2 | 0.00% |
| DAVID W RANCK3 Filed as: DAVID W. RANCK | PO BOX 277 EPHRATA, PA 17522 | AFLAC | $1 | — | $1 | 0.00% |
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 | 150 | 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) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AFLAC | 150 | $88K |
| Vision | AFLAC | 150 | $88K |
| Life insurance | AFLAC | 150 | $88K |
| Short-term disability | AFLAC | 150 | $88K |
| Other | AFLAC | 150 | $88K |
| 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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.