| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCCANN, JAMES3 | 115 SOUTH CENTRE ST POTTSVILLE, PA 17901 | HIGHMARK, INC. | $1K | $0 | $1K | 8.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES LLC | 300 SUMMERS ST STE 650 CHARLESTON, WV 25301 | HIGHMARK, INC. | $355 | $0 | $355 | 2.00% |
| CONSOLIDATED BENEFITS INC3 Filed as: CONSOLIDATED BENEFITS INC. | 2500 ELMERTON AVE HARRISBURG, PA 17110 | COMPANION LIFE INSURANCE COMPANY | $2K | $0 | $2K | 12.04% |
| STEVEN G SCHULTZ3 | 231 SOUTH 3RD STREET CATAWISSA, PA 17820 | AFLAC | $428 | $0 | $428 | 7.47% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 645 HAMILTON ST STE 1002 ALLENTOWN, PA 18101 | AFLAC | $321 | $0 | $321 | 5.61% |
| JEFFREY CHUBB3 | 349 W WALNUT TREE DR BLANDON, PA 19510 | AFLAC | $178 | $0 | $178 | 3.11% |
| SUSAN J CHUBB3 | 349 W WALNUT TREE DR BLANDON, PA 19510 | AFLAC | $67 | $0 | $67 | 1.17% |
| C A LUPP INC3 Filed as: C A LUPP INC. | 5010 E. TRINDLE RD. SUITE 201 MECHANICSBURG, PA 17050 | AFLAC | $49 | $0 | $49 | 0.86% |
| JOSEPH B MCGINTY JR3 Filed as: JOSEPH B MCGINTY JR. | 2202 CROSS CREEK DRIVE STE A13 MACUNGIE, PA 18062 | AFLAC | $46 | $0 | $46 | 0.80% |
| JUSTIN P ABRAHAM3 | 3841 HIGHPOINT DR ALLENTOWN, PA 18103 | AFLAC | $41 | $0 | $41 | 0.72% |
| MATTHEW G BERGER3 | 22 SUNNYRIDGE RD PHILADELPHIA, PA 19125 | AFLAC | $8 | $0 | $8 | 0.14% |
| ANGELA MASSARELLI3 Filed as: ANGELA UMOSELLA | 30 WATERFRONT WAY HAMMONTON, NJ 08037 | AFLAC | $3 | $0 | $3 | 0.05% |
| DARREN D RIDDLE3 Filed as: DARREN D. RIDDLE | 7850 AVONDALE TER. HARRISBURG, PA 17112 | AFLAC | $3 | $0 | $3 | 0.05% |
| RYAN K GOLDBERG3 Filed as: RYAN K. GOLDBERG | 103 CHURCH ST. #3 PHILADELPHIA, PA 19106 | AFLAC | $3 | $0 | $3 | 0.05% |
| MARTIN E BYSTROM3 Filed as: MARTIN E. BYSTROM | 253 MINORCA BEACH WAY APT. 305 NEW SMYRNA BEACH, FL 32169 | AFLAC | $3 | $0 | $3 | 0.05% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES LLC | 9 NORTH CENTRE STREET, SUITE 200 POTTSVILLE, PA 17901 | VISION BENEFITS OF AMERICA | $193 | $0 | $193 | 5.01% |
| GEARY L WALIZER3 Filed as: GEARY L WALIZERF | PO BOX 946 LOCK HAVEN, PA 17745 | AFLAC | $55 | $0 | $55 | 3.38% |
| FRED A REEDER3 | 109 WOODWARD AVENUE LOCK HAVEN, PA 17745 | AFLAC | $37 | $0 | $37 | 2.27% |
| JOHN M WASHO3 | 24956 WOLF BAY TER ORANGE BEACH, AL 36561 | AFLAC | $28 | $0 | $28 | 1.72% |
| IRENE E BROOKS3 | 101 COPPER BEECH LN WOMELSDORF, PA 19567 | AFLAC | $3 | $0 | $3 | 0.18% |
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 | 46 | 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) | 46 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | HIGHMARK, INC. | 62 | $18K |
| Vision | VISION BENEFITS OF AMERICA | 40 | $4K |
| Life insurance | COMPANION LIFE INSURANCE COMPANY | 65 | $16K |
| Other(3 contracts, 2 carriers) | COMPANION LIFE INSURANCE COMPANY | 65 | $24K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 65 | — |
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.