| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 4 RADNOR CORPORATE CENTER RADNOR, PA 19087 | KEYSTONE | $84K | $0 | $84K | 5.48% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4000 MIDLANTIC DRIVE SUITE 300 MOUNT LAUREL, NJ 08054 | DELTA DENTAL OF PENNSYLVANIA | $4K | $0 | $4K | 4.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4000 MIDLANTIC DRIVE SUITE 300 MOUNT LAUREL, NJ 08054 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $6K | $0 | $6K | 16.79% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $2K | $0 | $2K | 23.62% |
| RUSSELL L. DAYVAULT3 | 630 FORDHAM ROAD BALA CYNWYD, PA 19004 | AFLAC | $1K | $46 | $1K | 14.42% |
| SVETLANA ZEITLIN3 | 105 ADDIS DRIVE CHURCHVILLE, AZ 85286 | AFLAC | $582 | $0 | $582 | 7.05% |
| JOSE A SCHIENEMAN3 Filed as: JOSE A. SCHIENEMAN | 1881 SOUTH CARRIAGE LANE CHANDLER, AZ 85286 | AFLAC | $255 | $0 | $255 | 3.09% |
| BERNARD LYNN DAYVAULT3 | 630 FORDHAM ROAD BALA CYNWYD, PA 19004 | AFLAC | $158 | $0 | $158 | 1.91% |
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 | 175 | 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) | 175 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KEYSTONE | 208 | $1.5M |
| Dental | DELTA DENTAL OF PENNSYLVANIA | 243 | $97K |
| Vision | KEYSTONE | 208 | $1.5M |
| Life insurance | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 175 | $37K |
| Short-term disability | AFLAC | 16 | $8K |
| Long-term disability | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 175 | $37K |
| Prescription drug | KEYSTONE | 208 | $1.5M |
| Other(2 contracts, 2 carriers) | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 175 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 243 | — |
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.
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.