| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KIMMON R GUSEMAN3 Filed as: KIMMON GUSEMAN | 48 NICKMAN PLAZA LEMONT FURNACE, PA 15456 | AFLAC | $8K | $3K | $11K | 9.70% |
| GREG GUSEMAN3 | 48 NICKMAN PLAZA LEMONT FURNACE, PA 15456 | AFLAC | $2K | $609 | $2K | 2.11% |
| JAMES B. SEIFERT3 Filed as: JAMES SEIFERT | 157 MCCOY PLACE ROAD SEWICKLEY, PA 15143 | AFLAC | $1K | $628 | $2K | 1.85% |
| THOMAS R. COLEBANK3 Filed as: THOMAS COLCBANK | 322 FAIRVIEW AVENUE MASONTOWN, PA 15461 | AFLAC | $1K | $609 | $2K | 1.46% |
| ANDREA STEARNS3 Filed as: ANDREA STEARNS AND OTHER AGENTS | 501 HOLIDAY DRIVE FOSTER PLAZA A SUITE 120 PITTSBURGH, PA 15220 | AFLAC | $2K | $0 | $2K | 1.38% |
| MELISSA R FEATHER3 Filed as: MELISSA FEATHER | 10940 WILLIAM PENN ROAD IMLER, PA 16655 | AFLAC | $324 | $0 | $324 | 0.29% |
| MARIA J BENNETTI3 Filed as: MARIA BENNETTI | 2001 BELLMEADE DRIVE ALTOONA, PA 16602 | AFLAC | $319 | $0 | $319 | 0.29% |
| KIMMON R GUSEMAN3 Filed as: KIMMON R. GUSEMAN | 48 NICKMAN PLAZA LEMONT FURNACE, PA 15456 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $1K | $4K | 15.73% |
| GREGORY GUSEMAN3 | 48 NICKMAN PLAZA LEMONT FURNACE, PA 15456 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $903 | $2K | 7.98% |
| SHARI JEAN WALKER3 | 48 NICKMAN PLAZA LEMONT FURNACE, PA 15456 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $307 | $69 | $376 | 1.35% |
| THOMAS R. COLEBANK3 Filed as: THOMAS RAY COLEBANK | 322 FAIRVIEW AVENUE MASONTOWN, PA 15461 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $261 | $0 | $261 | 0.94% |
| BRETT WILLIAM WORKMAN3 | 14 SUSAN LANE LEMONT FURNACE, PA 15456 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $234 | $0 | $234 | 0.84% |
| BENECHOICE ENROLLMENT SOLUTIONS & T3 Filed as: BENECHOICE ENFOLLMENT SOLUTIONS | 1574 LITITZ PIKE LANCASTER, PA 17601 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.01% |
| ASHLY ELCOCK3 | 200 TATTLETOWN ROAD AARONSBURG, PA 16820 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| KIMMON R GUSEMAN3 Filed as: KIMMON R. GUSEMAN | 48 NICKMAN PLAZA LEMONT FURNACE, PA 15456 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $378 | $2K | 8.83% |
| GREGORY GUSEMAN3 | 48 NICKMAN PLAZA LEMONT FURNACE, PA 15456 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $315 | $126 | $441 | 1.84% |
| SHARI JEAN WALKER3 | 48 NICKMAN PLAZA LEMONT FURNACE, PA 15456 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $29 | $7 | $36 | 0.15% |
| BRETT WILLIAM WORKMAN3 | 14 SUSAN LANE LEMONT FURNACE, PA 15456 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.02% |
| THOMAS R. COLEBANK3 Filed as: THOMAS RAY COLEBANK | 322 FAIRVIEW AVENUE MASONTOWN, PA 15461 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.02% |
| USI INSURANCE SERVICES LLC3 | 1051 SHILOH ROAD STATE COLLEGE, PA 16801 | VISION BENEFITS OF AMERICA | $150 | $0 | $150 | 0.81% |
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 | 190 | 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) | 190 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UPMC HEALTH PLAN | 291 | $1.3M |
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 330 | $69K |
| Vision(2 contracts, 2 carriers) | AFLAC | 165 | $130K |
| Life insurance | AFLAC | 78 | $111K |
| Short-term disability | AFLAC | 78 | $111K |
| Long-term disability | AFLAC | 78 | $111K |
| Prescription drug | UPMC HEALTH PLAN | 291 | $1.3M |
| Other | AFLAC | 78 | $111K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 330 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.