| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PCI INSURANCE AGENCY3 Filed as: PCI INSURANCE, INC. | 417 WALNUT STREET HARRISBURG, PA 17101 | UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY | $2K | $0 | $2K | 10.14% |
| HIPPS CRYSTAL3 | 534 BETTY LANE COLUMBIA, PA 17512 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 7.09% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: ELEMENT RISK MANAGEMENT LLC | 310 N HIGH ST WEST CHESTER, PA 19380 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 5.13% |
| TROCKI GEORGE3 | 221 PROSPECT CIRCLE SHREWBURY, PA 17361 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $784 | $0 | $784 | 3.82% |
| SHANAMAN AMY JO3 | 84 MAIN ST PO BOX 71 STRAUSSTOWN, PA 19559 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $250 | $0 | $250 | 1.22% |
| CONWAY THERESA3 | 28 OAKGLADE DR HUMMELSTOWN, PA 17036 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $120 | $0 | $120 | 0.59% |
| PETERSON DOUGLAS C3 | 598 RIVERWOOD AVE PT PLEASANT, NJ 08742 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $106 | $0 | $106 | 0.52% |
| KULIKAUSKAS JANE3 | 3022 NESCO RD HAMMONTON, NJ 08037 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $76 | $0 | $76 | 0.37% |
| GELHARD DONNA3 | 3926 TIDEWOOD RD BALTO, MD 21220 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $36 | $0 | $36 | 0.18% |
| ROLLER DAVID3 | 80 DOLPHIN CIRCLE EAST BAYVILLE, NJ 08721 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $26 | $0 | $26 | 0.13% |
| BRISTOL ROBERT3 | 126 HARLOW POINTE COURT LANDENBERG, PA 19350 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $14 | $0 | $14 | 0.07% |
| PCI INSURANCE AGENCY3 Filed as: PCI INSURANCE, INC. | 417 WALNUT STREET HARRISBURG, PA 17101 | THE GUARDIAN LIFE INSURANCE COMPANY | $3K | $0 | $3K | 37.37% |
| PCI INSURANCE AGENCY3 Filed as: PCI INSURANCE, INC. | 417 WALNUT STREET HARRISBURG, PA 17101 | NATIONAL VISION ADMINISTRATOR, LLC | $421 | $0 | $421 | 8.61% |
| HIPPS CRYSTAL3 | 534 BETTY LANE COLUMBIA, PA 17512 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $227 | $0 | $227 | 5.36% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: ELEMENT RISK MANAGEMENT | 310 N HIGH STREET WEST CHESTER, PA 19380 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $167 | $0 | $167 | 3.95% |
| TROCKI GEORGE3 | 221 PROSPECT CIRCLE SHREWBURY, PA 17361 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $112 | $0 | $112 | 2.65% |
| SHANAMAN AMY JO3 | 84 MAIN ST PO BOX 71 STRAUSSTOWN, PA 19559 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $65 | $0 | $65 | 1.54% |
| PETERSON DOUGLAS C3 | 598 RIVERWOOD AVE PT PLEASANT, NJ 08742 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $12 | $0 | $12 | 0.28% |
| KULIKAUSKAS JANE3 | 3022 NESCO RD HAMMONTON, NJ 08037 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $10 | $0 | $10 | 0.24% |
| HIPPS CRYSTAL3 | 534 BETTY LN COLUMBIA, PA 17512 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $432 | $0 | $432 | 12.40% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: ELEMENT RISK MANAGEMENT LLC | 310 N HIGH ST WEST CHESTER, PA 19380 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $249 | $0 | $249 | 7.14% |
| TROCKI GEORGE3 | 221 PROSPECT CIR SHREWSBURY, PA 17361 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $77 | $0 | $77 | 2.21% |
| CONWAY THERESA3 | 28 OAKGLADE DR HUMMELSTOWN, PA 17036 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $59 | $0 | $59 | 1.69% |
| SHANAMAN AMY JO3 Filed as: SHANAMAN JO | 84 MAIN ST PO BOX 71 STRAUSSTOWN, PA 19559 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $55 | $0 | $55 | 1.58% |
| PETERSON DOUGLAS C3 | 598 RIVERWOOD AVE PT PLEASANT, NJ 08742 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $38 | $0 | $38 | 1.09% |
| KULIKAUSKA JANE3 | 3022 NESCO RD HAMMONTOWN, NJ 08037 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $29 | $0 | $29 | 0.83% |
| ROLLER DAVID3 | 80 DOLPHIN CIR E BAYVILLE, NJ 08721 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $11 | $0 | $11 | 0.32% |
| HIPPS CRYSTAL3 | 534 BETTY LANE COLUMBIA, PA 17512 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $537 | $0 | $537 | 18.46% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: ELEMENT RISK MANAGEMENT LLC | 310 N HIGH ST WEST CHESTER, PA 19380 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $306 | $0 | $306 | 10.52% |
| TROCKI GEORGE3 | 221 PROSPECT CIRCLE SHREWBURY, PA 17361 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $170 | $0 | $170 | 5.84% |
| PETERSON DOUGLAS C3 | 598 RIVERWOOD AVE PT PLEASANT, NJ 08742 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $39 | $0 | $39 | 1.34% |
| KULIKAUSKAS JANE3 | 3022 NESCO RD HAMMONTON, NJ 08037 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $20 | $0 | $20 | 0.69% |
| HIPPS CRYSTAL3 | 534 BETTY LANE COLUMBIA, PA 17512 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $130 | $0 | $130 | 4.67% |
| TROCKI GEORGE3 | 221 PROSPECT CIRCLE SHREWBURY, PA 17361 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $73 | $0 | $73 | 2.62% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: ELEMENT RISK MANAGEMENT LLC | 310 N HIGH ST WEST CHESTER, PA 19380 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $62 | $0 | $62 | 2.23% |
| SHANAMAN AMY JO3 | 84 MAIN ST PO BOX 71 STRAUSSTOWN, PA 19559 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $36 | $0 | $36 | 1.29% |
| PETERSON DOUGLAS C3 | 598 RIVERWOOD AVE PT PLEASANT, NJ 08742 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1 | $0 | $1 | 0.04% |
| HIPPS CRYSTAL3 | 534 BETTY LN COLUMBIA, PA 17512 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $113 | $0 | $113 | 9.65% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: ELEMENT RISK MANAGEMENT LLC | 310 N HIGH ST WEST CHESTER, PA 19380 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $69 | $0 | $69 | 5.89% |
| TROCKI GEORGE3 | 221 PROSPECT CIR SHREWSBURY, PA 17361 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $38 | $0 | $38 | 3.25% |
| BRISTOL ROBERT3 | 126 HARLOW POINTE CT LANDENBERG, PA 19350 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $10 | $0 | $10 | 0.85% |
| KULIKAUSKAS JANE3 | 3022 NESCO RD HAMMONTON, NJ 08037 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $8 | $0 | $8 | 0.68% |
| PETERSON DOUGLAS C3 | 598 RIVERWOOD AVE PT PLEASANT, NJ 08742 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $7 | $0 | $7 | 0.60% |
| HIPPS CRYSTAL3 | 534 BETTY LN COLUMBIA, PA 17512 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $23 | $0 | $23 | 2.05% |
| SHANAMAN AMY JO3 | 84 MAIN ST PO BOX 71 STRAUSSTOWN, PA 19559 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $18 | $0 | $18 | 1.61% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: ELEMENT RISK MANAGEMENT LLC | 310 N HIGH ST WEST CHESTER, PA 19380 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $17 | $0 | $17 | 1.52% |
| TROCKI GEORGE3 | 221 PROSPECT CIR SHREWSBURY, PA 17361 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $10 | $0 | $10 | 0.89% |
| HIPPS CRYSTAL3 | 534 BETTY LN COLUMBIA, PA 17512 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $160 | $0 | $160 | 14.52% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: ELEMENT RISK MANAGEMENT LLC | 310 N HIGH ST WEST CHESTER, PA 19380 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $91 | $0 | $91 | 8.26% |
| TROCKI GEORGE3 | 221 PROSPECT CIRCLE SHREWBURY, PA 17361 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $19 | $0 | $19 | 1.72% |
| SHANAMAN AMY JO3 | 84 MAIN ST PO BOX 71 STRAUSSTOWN, PA 19559 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $18 | $0 | $18 | 1.63% |
| KULIKAUSKAS JANE3 | 3022 NESCO RD HAMMONTON, NJ 08037 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $13 | $0 | $13 | 1.18% |
| PETERSON DOUGLAS C3 | 598 RIVERWOOD AVE PT PLEASANT, NJ 08742 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $10 | $0 | $10 | 0.91% |
| ROLLER DAVID3 | 80 DOLPHIN CIRCLE E BAYVILLE, NJ 08721 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $5 | $0 | $5 | 0.45% |
| HIPPS CRYSTAL3 | 534 BETTY LANE COLUMBIA, PA 17512 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $57 | $0 | $57 | 17.59% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: ELEMENT RISK MANAGEMENT LLC | 310 N HIGH STREET WEST CHESTER, PA 19380 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $29 | $0 | $29 | 8.95% |
| KULKAUSKAS JANE3 | 3022 NESCO RD HAMMONTON, NJ 08037 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $10 | $0 | $10 | 3.09% |
| PETERSON DOUGLAS C3 | 598 RIVERWOOD AVE PT PLEASANT, NJ 08742 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4 | $0 | $4 | 1.23% |
| HIPPS CRYSTAL3 | 534 BETTY LANE COLUMBIA, PA 17512 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $43 | $0 | $43 | 15.19% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: ELEMENT RISK MANAGEMENT LLC | 310 N HIGH ST WEST CHESTER, PA 19380 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $22 | $0 | $22 | 7.77% |
| KALIKAUSKA JANE3 | 3022 NESCO RD HAMMONTON, NJ 08037 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $7 | $0 | $7 | 2.47% |
| PETERSON DOUGLAS C3 | 598 RIVERWOOD AVE PT PLEASANT, NJ 08742 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3 | $0 | $3 | 1.06% |
| HIPPS CRYSTAL3 | 534 BETTY LN COLUMBIA, PA 17512 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $36 | $0 | $36 | 60.00% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: ELEMENT RISK MANAGEMENT LLC | 310 N HIGH ST WEST CHESTER, PA 19380 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $15 | $0 | $15 | 25.00% |
| PETERSON DOUGLAS C3 | 598 RIVERWOOD AVE PT PLEASANT, NJ 08742 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2 | $0 | $2 | 3.33% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PCI (PA CHAMBER INSURANCE) EIN 25-1784573 BROKER | Insurance agents and brokers Service code 22 | — | $15K |
| THE BENECON GROUP, LLC EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $13K |
| CAPITAL BLUE CROSS EIN 23-0455154 ADMIN | Claims processing Service code 12 | — | $4K |
| CONNECTCARE 3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $3K |
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 | 50 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 51 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY | 64 | $23K |
| Vision | NATIONAL VISION ADMINISTRATOR, LLC | 57 | $5K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY | 100 | $8K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | HM LIFE INSURANCE COMPANY | 50 | $273K |
| Other(12 contracts, 2 carriers) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 100 | $46K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 100 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.