| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAMES I IDDINGS SR3 Filed as: JAMES IDDINGS SR | PO BOX 338 WYALUSING, PA 18853 | AFLAC | $8 | $0 | $8 | 0.05% |
| JOHM W WASHO3 | 24956 WOLF BAY TER ORANGE BEACH, AL 36561 | AFLAC | $7 | $0 | $7 | 0.05% |
| IRENE E BROOKS3 | 101 COPPER BEECH LN WORMELSDORF, PA 19567 | AFLAC | $1 | $0 | $1 | 0.01% |
| MARK D BARBIER3 | 20 CROYDON LN OAK BROOK, IL 60523 | AFLAC | $0 | $0 | $0 | 0.00% |
| BARBARA A KENNEDY3 Filed as: BARBARA ANN KENNEDY | 122 EAST WATER ST MUNCY, PA 17756 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $48 | $3K | 35.92% |
| GARY D DAVIS3 | 1 ARCTURUS DR SEWELL, NJ 08080 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $271 | $76 | $347 | 4.14% |
| BONCHER BENEFITS, INC.3 Filed as: BONCHER BENEFITS INC | 288 COLD SPRING DRIVE JIM THORPE, PA 18229 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $225 | $0 | $225 | 2.68% |
| KILMER LIFE AGENCY INC3 Filed as: KILMER INSURANCE AGENCY INC | PO BOX 337 WYALUSING, PA 18853 | AFLAC | $1K | $0 | $1K | — |
| BARBARA A KENNEDY3 Filed as: BARBARA KENNEDY | 122 E WATER ST MUNCY, PA 17756 | AFLAC | $548 | $0 | $548 | — |
| JOSEPH B MCGINTY JR3 | 2202 CROSS CREEK RD MACUNGIE, PA 18062 | AFLAC | $148 | $0 | $148 | — |
| JEFFREY CHUBB3 Filed as: JEFFREY C CHUBB | 349 W WALNUT TREE DR BLANDON, PA 19510 | AFLAC | $91 | $0 | $91 | — |
| DANIEL CERO3 | 1936 MOUNT VIEW AVE MOUNTOURSVILLE, PA 17754 | AFLAC | $60 | $0 | $60 | — |
| KEVIN D NOLL3 | PO BOX 29 ALBRIGHTSVILLE, PA 18210 | AFLAC | $43 | $0 | $43 | — |
| GEARY L WALIZER3 | PO BOX 946 LOCK HAVEN, PA 17745 | AFLAC | $14 | $0 | $14 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HIGHMARK (CENTRAL) EIN 23-1294723 ADMIN | Claims processing Service code 12 | — | $26K |
| CUMMINGS INSURANCE AGENCY EIN 23-2732076 BROKER | Insurance agents and brokers Service code 22 | — | $23K |
| THE BENECON GROUP LLC EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $15K |
| HIGHMARK BCBS NEPA EIN 45-3674900 ADMIN | Claims processing Service code 12 | — | $9K |
| CONNECTCARE3 LLC EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $4K |
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 | 74 | 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) | 74 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY | 0 | $0 |
| Life insurance | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 7 | $8K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 74 | $278K |
| Other(2 contracts) | AFLAC | 16 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 74 | — |
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.