| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 3.55% |
| THOMAS M TEGLER3 Filed as: THOMAS J. BELMONT | 13 OAK GLEN DRIVE MALVERN, PA 19355 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 2.13% |
| AMERIHEALTH ADMINISTRATORS INC3 Filed as: AMERIHEALTH ADMINISTRATORS, INC. | PO BOX 21545 EAGAN, MN 55121 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $251 | $0 | $251 | 0.28% |
| SJC BUSINESS SERVICES LLC3 Filed as: SJC BUSINESS SERVICES, LLC | PO BOX 84 GREEN LANE, PA 18054 | AFLAC | $4K | $0 | $4K | 6.55% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $2K | $0 | $2K | 3.85% |
| MJ INSURANCE3 Filed as: BRUCE CAMPO AND VARIOUS AGENTS | 1726 BECKER ROAD GREEN LANE, PA 18054 | AFLAC | $1K | $3 | $1K | 1.70% |
| EDWARD F MROWKA JR3 Filed as: EDWARD F. MROWKA, JR. | 5106 TIMBER LANE SCHNECKSVILLE, PA 18078 | AFLAC | $649 | $0 | $649 | 1.04% |
| JACQUELINE M EBERZ3 Filed as: JACQUELINE M. EBERTZ | 98 LAMP POST ROAD NEW BRITAIN, PA 18901 | AFLAC | $378 | $0 | $378 | 0.61% |
| ANDREW J JUNIKIEWICZ JR3 Filed as: ANDREW J. JUNIKIEWICZ, JR. | 98 LAMP POST ROAD NEW BRITAIN, PA 18901 | AFLAC | $308 | $3 | $311 | 0.50% |
| CALEB RUSSELL SMITH3 | 103 PINEHURST WAY GILBERTSVILLE, PA 18054 | AFLAC | $199 | $16 | $215 | 0.34% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $0 | $4K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 100 MATSONFORD ROAD RADNOR, PA 19087 | VISION SERVICE PLAN | $769 | $0 | $769 | 7.59% |
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 | 303 | 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) | 303 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 114 | $88K |
| Vision | VISION SERVICE PLAN | 119 | $10K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 303 | $126K |
| Short-term disability | AFLAC | 73 | $62K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 303 | $37K |
| Other(4 contracts, 4 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 303 | $201K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 303 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.