| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEFCHOK & ASSOCIATES3 | 233 WEST PITTSBURGH STREET GREENSBURG, PA 15601 | UPMC HEALTH OPTIONS | $18K | — | $18K | 1.85% |
| SEFCHOK & ASSOCIATES3 | 233 WEST PITTSBURGH STREET GREENSBURG, PA 15601 | UPMC HEALTH BENEFITS | $14K | — | $14K | 34.98% |
| GARY S SEFCHOK3 Filed as: GARY SEFCHOK | 233 WEST PITTSBURGH STREET GREENSBURG, PA 15601 | DEAR BORN NATIONAL | $5K | — | $5K | 14.22% |
| GARY S SEFCHOK3 Filed as: GARY SEFCHOK | 233 WEST PITTSBURGH STRET GREENSBURG, PA 15601 | DELTA DENTAL OF PA | $2K | — | $2K | 6.00% |
| JANICE L ROSKEY3 | PO BOX 212 BOVARD, PA 15619 | AFLAC | $531 | $68 | $599 | 5.97% |
| BENEFIT ALTERNATIVES INC3 | 12 W PITTSBURGH STREET GREENSBURG, PA 15601 | AFLAC | $522 | $58 | $580 | 5.78% |
| RICHARD LOWMAN3 Filed as: RICHARD E LOWMAN II | 516 GRANDVIEW AVENUE APT 7 PITTSBURGH, PA 15211 | AFLAC | $259 | $25 | $284 | 2.83% |
| ANDREA STEARNS3 | 1195 WASHINGTON PIKE BRIDGEVILLE, PA 15017 | AFLAC | $182 | $25 | $207 | 2.06% |
| MARIO HAIFA3 | 1195 WASHINGTON PIKE BRIDGEVILLE, PA 15017 | AFLAC | $71 | $25 | $96 | 0.96% |
| RITA BERGSTEIN BENEFITS LLC3 | 12260 STATE RT 30 N HUNTINGDON, PA 15642 | AFLAC | $82 | — | $82 | 0.82% |
| RAMKRISHNA AGARWAL3 | 106 SHEFFIELD LANE MC MURRAY, PA 15317 | AFLAC | $73 | — | $73 | 0.73% |
| GARY S SEFCHOK3 Filed as: GARY S. SEFCHOK | PO BOX 1737 GREENSBURG, PA 15601 | AFLAC | $53 | — | $53 | 0.53% |
| JOHN W DRAY3 | 123 THOMAS RD MC MURRAY, PA 15317 | AFLAC | $40 | — | $40 | 0.40% |
| DOMINICK J LACARIA3 | 216 ROSCOMMON PLACE MC MURRAY, PA 15317 | AFLAC | $40 | — | $40 | 0.40% |
| DAVID K AGARWAL3 | 106 SHEFFIELD LANE MC MURRAY, PA 15317 | AFLAC | $29 | — | $29 | 0.29% |
| KAREN L DENNIS3 | 101 PATRIOT LN SEWICKLEY, PA 15143 | AFLAC | $21 | — | $21 | 0.21% |
| TYE ELLIOTT3 | 1300 N INDEPENDENCE CT GERMANTOWN HILLS, IL 61548 | AFLAC | $18 | — | $18 | 0.18% |
| DANIEL R JUDY3 | 231 WALTERS MILL RD SOMERSET, PA 15501 | AFLAC | $18 | — | $18 | 0.18% |
| KRISTIN J QUINLAN3 | 137 SEMICONON LN RENFREW, PA 16053 | AFLAC | $17 | — | $17 | 0.17% |
| BRIAN W PATTEN3 | 120 MARGUERITE DR CRANBERRY TWSP, PA 16066 | AFLAC | $10 | — | $10 | 0.10% |
| DANIEL D BUSATTO3 | 721 SEWICKLEY STREET GREENSBURG, PA 15601 | AFLAC | $10 | — | $10 | 0.10% |
| BRADLEY KAUFFMAN3 | 315 GREEN RIDGE ROAD NEW CASTLE, PA 16105 | AFLAC | $8 | — | $8 | 0.08% |
| DIVERSIFIED SOLUTIONS GROUP INC3 | PO BOX 211 YOUNGWOOD, PA 15697 | AFLAC | $6 | — | $6 | 0.06% |
| GARY S SEFCHOK3 Filed as: GARY SEFCHOK | 233 WEST PITTSBURGH STREET GREENSBURG, PA 15601 | VISION BENEFITS OF AMERICA | $214 | — | $214 | 3.04% |
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 | 158 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 158 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UPMC HEALTH OPTIONS | 241 | $988K |
| Dental(2 contracts, 2 carriers) | UPMC HEALTH BENEFITS | 288 | $74K |
| Vision | VISION BENEFITS OF AMERICA | 140 | $7K |
| Life insurance | DEAR BORN NATIONAL | 93 | $37K |
| Short-term disability | AFLAC | 18 | $10K |
| Long-term disability | DEAR BORN NATIONAL | 93 | $37K |
| Prescription drug | UPMC HEALTH OPTIONS | 241 | $988K |
| Other | DEAR BORN NATIONAL | 93 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 288 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.