| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: THE HDH GROUP | 210 SIXTH AVENUE 30TH FLOOR PITTSBURGH, PA 15222 | AETNA | $31K | — | $31K | 2.79% |
| ASSUREDPARTNERS3 Filed as: THE HDH GROUP INC. | 210 SIXTH AVENUE 30TH FLOOR PITTSBURGH, PA 15222 | MEDICAL ASSOCIATES HEALTH PLANS | $2K | — | $2K | 5.32% |
| JOHN W DRAY3 Filed as: JOHN W. DRAY | 123 THOMAS ROAD MCMURRAY, PA 15317 | AFLAC | $3K | $103 | $3K | 11.85% |
| MICHAEL A. BITTEL3 Filed as: MICHAEL ANTHONY BITTEL | 129 MARION DRIVE CANONSBURG, PA 15317 | AFLAC | $260 | $21 | $281 | 1.06% |
| RIFFE CONSULTING GROUP LLC3 | 219 TIMBER RDG CRANBERRY TOWNSHIP, PA 16066 | AFLAC | $223 | — | $223 | 0.84% |
| JEFFREY CORREAL3 | 125 TECHNOLOGY DRIVE SUITE 201 CANONSBURG, PA 15317 | AFLAC | $208 | — | $208 | 0.78% |
| ELIZABETH MARIE LANGEVIN3 Filed as: ELIZABETH ANN RIFFE | 219 TIMBER RDG CRANBERRY TOWNSHIP, PA 16066 | AFLAC | $205 | — | $205 | 0.77% |
| MARIO HAIFA3 | 216 WARWICK DRIVE PITTSBURGH, PA 15241 | AFLAC | $180 | — | $180 | 0.68% |
| RITA BERGSTEIN BENEFITS LLC3 | 12260 STATE ROUTE 30 NORTH HUNTINGDON, PA 15642 | AFLAC | $150 | — | $150 | 0.56% |
| JEFFREY CORREAL3 | 420 GENNY LANE UNIONTOWN, PA 15401 | AFLAC | $119 | $21 | $140 | 0.53% |
| MARJORIE B. YACOPETTI3 | P.O.BOX 2152 LODI, CA 95241 | AFLAC | $57 | — | $57 | 0.21% |
| JOHN H. SCHNEIDER3 | 8990 SW ZANDER COURT PORTLAND, OR 97223 | AFLAC | $34 | — | $34 | 0.13% |
| JOY GRUBE PADGELEK3 | 1195 WASHINGTON PIKE SUITE 300 BRIDGEVILLE, PA 15017 | AFLAC | $29 | — | $29 | 0.11% |
| JAMES BRADLEY SEIFERT3 | 157 MCCOY PLACE ROAD SEWICKLEY, PA 15143 | AFLAC | $28 | — | $28 | 0.11% |
| BRIAN W PATTEN3 Filed as: BRIAN W. PATTEN | 120 MARGUERITE DRIVE SUITE 101 CRANBERRY TOWNSHIP, PA 16066 | AFLAC | $27 | — | $27 | 0.10% |
| APRIL MARIE ROBERTS3 | 3540 SPRINGFIELD DRIVE FAIRFIELD, CA 94534 | AFLAC | $23 | — | $23 | 0.09% |
| BARRY A WHITE3 Filed as: BARRY A. WHITE | 4506 BANTAM WAY ELK GROVE, CA 95758 | AFLAC | $21 | — | $21 | 0.08% |
| ROBERT PILKENTON3 Filed as: ROBERT L. PILKENTON | 1100 CORPORATE WAY SUITE 100 SACREMENTO, CA 95831 | AFLAC | $19 | — | $19 | 0.07% |
| JAMES S SARANTIS3 Filed as: JAMES S. SARANTIS | 2281 LAVA RIDGE COURT SUITE 130 ROSEVILLE, CA 95661 | AFLAC | $10 | — | $10 | 0.04% |
| GUSTAVO ARRIAGA II3 Filed as: GUSTAVO ARRIAGA | 5237 NORTH RIVERSIDE DRIVE SUITE 207 FORT WORTH, TX 76137 | AFLAC | $7 | — | $7 | 0.03% |
| LES HEINSEN INS SERVICES INC3 Filed as: LES HEINSEN INS. SERVICES INC. | 4416 VIA PALAGIO FAIR OAKS, CA 95628 | AFLAC | $6 | — | $6 | 0.02% |
| ANA PATRICIA ARRIAGA3 | 980 ARLINGTON CIRCLE WOODLAND, CA 95695 | AFLAC | $6 | — | $6 | 0.02% |
| GUSTAVO ARRIAGA II3 Filed as: GUSTAVO ARRIAGA | 1140 MANGROVE AVENUE SUITE D CHICO, CA 95926 | AFLAC | $4 | — | $4 | 0.02% |
| ETHAN R. RIFFE3 | 219 TIMBER RDG CRANBERRY TOWNSHIP, PA 16066 | AFLAC | $2 | — | $2 | 0.01% |
| NICHOLAS E VIGIL3 Filed as: NICHOLAS E. VIGIL | 120 ROCKBOLT CIRCLE FOLSOM, CA 95630 | AFLAC | $1 | — | $1 | 0.00% |
| AMY E COHEN3 Filed as: AMY MARIE LUDWICK | 305 TENTH STREET SACREMENTO, CA 95814 | AFLAC | $1 | — | $1 | 0.00% |
| MICHAEL C WALKER3 Filed as: MICHAEL JAMES RHODD | 4160 GREEN VALLEY ROAD FAIRFIELD, CA 94534 | AFLAC | $1 | — | $1 | 0.00% |
| ASSUREDPARTNERS3 Filed as: THE HDH GROUP INC. | 210 SIXTH AVENUE 30TH FLOOR PITTSBURGH, PA 15222 | VISION BENEFITS OF AMERICA | $628 | — | $628 | 5.00% |
| GATEWAY BENEFITS DBA THE3 | 210 SIXTH AVENUE 30TH FLOOR PITTSBURGH, PA 15222 | CIGNA | $980 | — | $980 | 10.00% |
| GATEWAY BENEFITS DBA THE3 | 210 SIXTH AVENUE 30TH FLOOR PITTSBURGH, PA 15222 | CIGNA | $1K | — | $1K | 15.00% |
| GATEWAY BENEFITS DBA THE3 | 210 SIXTH AVENUE 30TH FLOOR PITTSBURGH, PA 15222 | CIGNA | $239 | — | $239 | 10.00% |
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 | 223 | 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) | 223 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA | 141 | $1.1M |
| Vision | VISION BENEFITS OF AMERICA | 135 | $13K |
| Life insurance(2 contracts, 2 carriers) | AFLAC | 223 | $36K |
| Long-term disability | CIGNA | 223 | $10K |
| Prescription drug | AETNA | 141 | $1.1M |
| Other(2 contracts, 2 carriers) | AFLAC | 223 | $29K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 223 | — |
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.