| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEVEN G SCHULTZ3 | 264 LEONARD STREET BLOOMSBURG, PA 17815 | AFLAC | $2K | $89 | $2K | 6.30% |
| JEFFREY CHUBB3 | 520 W FOURTH STREET STE 1A WILLIAMSPORT, PA 17701 | AFLAC | $582 | $18 | $600 | 2.28% |
| JOSEPH B MCGINTY JR3 | 520 W FOURTH STREET STE 1A WILLIAMSPORT, PA 17701 | AFLAC | $307 | $18 | $325 | 1.23% |
| C A LUPP INC3 Filed as: C A LUPP, INC. | 441 FRIENDSHIP RD STE 102 HARRISBURG, PA 17111 | AFLAC | $262 | — | $262 | 0.99% |
| SUSAN J CHUBB3 | 520 W FOURTH STREET STE 1A WILLIAMSPORT, PA 17701 | AFLAC | $229 | — | $229 | 0.87% |
| MG BERGER INC3 | 1020 N DELAWARE AVE 4TH FLOOR PHILADELPHIA, PA 19125 | AFLAC | $71 | $18 | $89 | 0.34% |
| GEARY L WALIZER3 | PO BOX 946 LOCK HAVEN, PA 17745 | AFLAC | $46 | — | $46 | 0.17% |
| FRED A REEDER3 | 380 E MAIN STREET LOCK HAVEN, PA 17745 | AFLAC | $31 | — | $31 | 0.12% |
| JOHN M WASHO3 | 106 CEDAR BLUFF CT ALEDO, TX 76008 | AFLAC | $23 | — | $23 | 0.09% |
| MARK D BARBIER3 | 802 DEER TRAIL LN OAK BROOK, IL 60523 | AFLAC | $10 | — | $10 | 0.04% |
| CONSOLIDATED BENEFITS INC3 Filed as: CONSOLIDATED BENEFITS INC. | 2500 ELMERTON AVE HARRISBURG, PA 17177 | COMPANION LIFE | $4K | $10 | $4K | 16.34% |
| CONSOLIDATED BENEFITS INC3 Filed as: CONSOLIDATED BENEFITS INC. | 2500 ELMERTON AVE HARRISBURG, PA 17177 | COMPANION LIFE | $869 | $10 | $879 | 22.74% |
| CONSOLIDATED BENEFITS INC3 Filed as: CONSOLIDATED BENEFITS INC. | 2500 ELMERTON AVE. HARRISBURG, PA 17177 | COMPANION LIFE | $56 | $10 | $66 | 19.24% |
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 | 133 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 28 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 161 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AFLAC | 37 | $26K |
| Life insurance(3 contracts) | COMPANION LIFE | 133 | $27K |
| Short-term disability | AFLAC | 37 | $26K |
| Long-term disability | AFLAC | 37 | $26K |
| Stop-loss / reinsurancereinsurance | AVALON INSURANCE COMPANY | 105 | $222K |
| Other(4 contracts, 2 carriers) | AFLAC | 133 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 133 | — |
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.