| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KEY INSURANCE & BENEFIT SERVICES3 | 726 EXCHANGE STREET SUITE 900 BUFFALO, NY 14210 | HIGHMARK | $28K | — | $28K | 0.97% |
| FIRST NIAGARA RISK MANAGEMENT3 Filed as: FIRST NIAGARA RISK MANAGEMENT, INC. | 1215 MANOR DRIVE SUITE 200 MECHANICSBURG, PA 170554900 | METROPOLITAN LIFE INSURANCE COMPANY | $20K | $2K | $22K | 10.11% |
| ROBERT J ELBIN JR3 Filed as: ROBERT J ELBIN JR. | 430 FORBES ROAD BEDFORD, PA 15522 | AFLAC | $759 | — | $759 | 4.49% |
| JOHN E HRIVNAK3 | 3900 INDUSTRIAL PARK DRIVE SUITE 11 ALTOONA, PA 16602 | AFLAC | $309 | — | $309 | 1.83% |
| JENNIFER ROBIN HRIVNAK3 | 3900 INDUSTRIAL PARK DRIVE SUITE 11 ALTOONA, PA 16602 | AFLAC | $232 | — | $232 | 1.37% |
| SMITH BENEFITS CONSULTING GROUP3 | 810 RIVER AVENUE SUITE 230 PITTSBURGH, PA 15212 | AFLAC | $144 | — | $144 | 0.85% |
| MARIO HAIFA3 | 1195 WASHINGTON PIKE SUITE 300 BRIDGEVILLE, PA 15017 | AFLAC | $98 | — | $98 | 0.58% |
| DANIEL J KUDRNA3 | 2302 SHANNON DR VALPARAISO, IN 46383 | AFLAC | $95 | — | $95 | 0.56% |
| VICKI J VELTRI3 | 1175 BALKAN DRIVE PITTSBURGH, PA 15239 | AFLAC | $72 | — | $72 | 0.43% |
| DEBRA L CARL3 Filed as: DEBRA L. CARL | 2042 STATE ROUTE 61 SUNBURY, PA 17801 | AFLAC | $70 | — | $70 | 0.41% |
| BRIAN W PATTEN3 | 120 MARGUERITE DRIVE STE 101 CRANBERRY TOWNSHIP, PA 16066 | AFLAC | $30 | — | $30 | 0.18% |
| CLYDE MOSTOLLER3 | 170 KERSCHENSTEINER DRIVE MEYERSDALE, PA 15552 | AFLAC | $28 | — | $28 | 0.17% |
| DONALD J MASON3 | 321 NIVER JUNCTION ROAD BERLIN, PA 15530 | AFLAC | $23 | — | $23 | 0.14% |
| TYE ELLIOTT3 | 1300 N INDEPENDENCE COURT GERMANTOWN HILLS, IL 61548 | AFLAC | $20 | — | $20 | 0.12% |
| RUTH E CURRY3 | PO BOX 106 FORD CITY, PA 16226 | AFLAC | $16 | — | $16 | 0.09% |
| JEFFREY S FOLK3 | 8472 FRIENDSVILLE ROAD FRIENDSVILLE, MD 21531 | AFLAC | $15 | — | $15 | 0.09% |
| S&T EVERGREEN INSURANCE LLC3 Filed as: S T EVERGREEN INSURANCE LLC | PO BOX 505 INDUSTRIAL PARK DRIVE EBENSBURG, PA 15931 | AFLAC | $14 | — | $14 | 0.08% |
| JAMES G BRANDT3 | 47 MARVIN STREET PORT MATILDA, PA 16870 | AFLAC | $13 | — | $13 | 0.08% |
| DANIEL R JUDY3 | 231 WALTERS MILL ROAD SOMERSET, PA 15501 | AFLAC | $10 | — | $10 | 0.06% |
| KIMMON R GUSEMAN3 | 48 NICKMAN PLZ LEMONT FURNACE, PA 15456 | AFLAC | $8 | — | $8 | 0.05% |
| BILLY M CRAIN3 | 57 PICKERING STREET BROOKVILLE, PA 15825 | AFLAC | $8 | — | $8 | 0.05% |
| DEBORAH SUE RAY3 | 116 DUFFY ROAD FREEPORT, PA 16229 | AFLAC | $7 | — | $7 | 0.04% |
| SUZANNE M COCCAGNA3 | 266 W OWENS AVENUE DERRY, PA 15627 | AFLAC | $7 | — | $7 | 0.04% |
| JOY GRUBE PADGELEK3 | 1195 WASHINGTON PIKE SUITE 300 BRIDGEVILLE, PA 15017 | AFLAC | $3 | — | $3 | 0.02% |
| DOMINICK J LACARIA3 | 216 ROSCOMMON PLACE MCMURRAY, PA 15317 | AFLAC | $2 | — | $2 | 0.01% |
| JOHN P FRICK3 | 724 HIGH STREET EXT DUNBAR, PA 15431 | AFLAC | $1 | — | $1 | 0.01% |
| THE TORRES GROUP LLC3 Filed as: THE TORRES GROUP, LLC | 1750 FARMINTON CIRCLE WELLINTON, TN 37919 | AFLAC | $1 | — | $1 | 0.01% |
| TIMOTHY R QUINLAN3 Filed as: TIMOTHY R. QUINLAN | 137 SEMICONON LN RENFREW, PA 16053 | AFLAC | $1 | — | $1 | 0.01% |
| KEY INSURANCE & BENEFIT SERVICES3 | 726 EXCHANGE STREET SUITE 9 BUFFALO, NY 14210 | FEDERAL INSURANCE COMPANY | $713 | $83 | $796 | 16.76% |
| DONALD J MASON3 | 321 NIVER JUNCTION ROAD BERLIN, PA 15530 | AFLAC | $101 | — | $101 | 5.76% |
| ROBERT J ELBIN JR3 | 430 FORBES ROAD BEDFORD, PA 15522 | AFLAC | $38 | — | $38 | 2.17% |
| DANIEL R JUDY3 | 231 WALTERS MILL ROAD SOMERSET, PA 15501 | AFLAC | $22 | — | $22 | 1.25% |
| JENNIFER ROBIN HRIVNAK3 | 3900 INDUSTRIAL PARK DRIVE SUITE 11 ALTOONA, PA 16602 | AFLAC | $20 | — | $20 | 1.14% |
| JOHN E HRIVNAK3 | 3900 INDUSTRIAL PARK DRIVE SUITE 11 ALTOONA, PA 16602 | AFLAC | $9 | — | $9 | 0.51% |
| MARIO HAIFA3 | 1195 WASHINGTON PIKE SUITE 300 BRIDGEVILLE, PA 15017 | AFLAC | $6 | — | $6 | 0.34% |
| DOMINICK J LACARIA3 Filed as: DOMINICK LACARIA | 216 ROSCOMMON PLACE MCMURRAY, PA 15317 | AFLAC | $6 | — | $6 | 0.34% |
| S&T EVERGREEN INSURANCE LLC3 Filed as: S T EVERGREEN INSURANCE LLC | PO BOX 505 INDUSTRIAL PARK DRIVE EBENSBURG, PA 15931 | AFLAC | $4 | — | $4 | 0.23% |
| IRENE E BROOKS3 | 1253 WEST LEESPORT ROAD LEESPORT, PA 19533 | AFLAC | $4 | — | $4 | 0.23% |
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 | 230 | 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) | 230 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK | 621 | $2.9M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 633 | $215K |
| Vision | HEARTLAND | 617 | $18K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 633 | $215K |
| Short-term disability(2 contracts) | AFLAC | 8 | $19K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 633 | $215K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 633 | $220K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 633 | — |
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.