| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIAMANT & ASSOC LLC3 Filed as: DIAMANT YITZCHOK | 1776 AVENUE OF THE STATES STE 101 LAKEWOOD, NJ 08701 | HIGHMARK, INC. | $17K | $0 | $17K | 2.94% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 100 PINEWOOD LANE STE 301 WARRENDALE, PA 15086 | HIGHMARK, INC. | $9K | $0 | $9K | 1.47% |
| HIPPS CRYSTAL3 | 534 BETTY LANE COLUMBIA, PA 17512 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | $0 | $3K | 10.33% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: ELEMENT RISK MANAGEMENT LLC | 310 N HIGH ST WEST CHESTER, PA 19380 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | $0 | $2K | 5.95% |
| TROCKI GEORGE3 Filed as: TROCKI GEORGE A | 221 PROSPECT CIRCLE SHREWSBURY, PA 17361 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $701 | $0 | $701 | 2.70% |
| PETERSON DOUGLAS C3 | 598 RIVERWOOD AVE PT PLEASANT, NJ 08742 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $226 | $0 | $226 | 0.87% |
| SHANAMAN AMY JO3 | 84 MAIN ST PO BOX 71 STRAUSSTOWN, PA 19559 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $196 | $0 | $196 | 0.76% |
| DAY AUBREY L3 | 6806 PINE HILL DR COLUMBIA, PA 17512 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $121 | $0 | $121 | 0.47% |
| GELHARD DONNA3 | 3926 TIDEWOOD RD BALTO, MD 21220 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $37 | $0 | $37 | 0.14% |
| KULIKAUSKAS JANE3 | 3022 NESCO RD HAMMONTON, NJ 08037 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $21 | $0 | $21 | 0.08% |
| BRISTOL ROBERT3 | 126 HARLOW POINTE COURT LANDENBERG, PA 19350 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $15 | $0 | $15 | 0.06% |
| ROLLER DAVID3 | 80 DOLPHIN CIRCLE EAST BAYVILLE, NJ 08721 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $9 | $0 | $9 | 0.03% |
| HIPPS CRYSTAL3 | 534 BETTY LANE COLUMBIA, PA 17512 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | $0 | $2K | 28.29% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: ELEMENT RISK MANAGEMENT LLC | 310 N HIGH ST WEST CHESTER, PA 19380 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $687 | $0 | $687 | 12.12% |
| PETERSON DOUGLAS C3 | 598 RIVERWOOD AVE PT PLEASANT, NJ 08742 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $146 | $0 | $146 | 2.58% |
| HIPPS CRYSTAL3 | 534 BETTY LANE COLUMBIA, PA 17512 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $621 | $0 | $621 | 11.28% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: ELEMENT RISK MANAGEMENT | 310 N HIGH STREET WEST CHESTER, PA 19380 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $341 | $0 | $341 | 6.20% |
| TROCKI GEORGE3 | 221 PROSPECT CIRCLE SHREWBURY, PA 17361 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $93 | $0 | $93 | 1.69% |
| SHANAMAN AMY JO3 | 84 MAIN ST PO BOX 71 STRAUSSTOWN, PA 19559 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $58 | $0 | $58 | 1.05% |
| DAY AUBREY L3 | 3806 PINE HILL DR COLUMBIA, PA 17512 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $43 | $0 | $43 | 0.78% |
| PETERSON DOUGLAS C3 | 598 RIVERWOOD AVE PT PLEASANT, NJ 08742 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $36 | $0 | $36 | 0.65% |
| KULIKAUSKAS JANE3 | 3022 NESCO RD HAMMONTON, NJ 08037 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3 | $0 | $3 | 0.05% |
| HIPPS CRYSTAL3 | 534 BETTY LN COLUMBIA, PA 17512 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $823 | $0 | $823 | 18.50% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: ELEMENT RISK MANAGEMENT LLC | 310 N HIGH ST WEST CHESTER, PA 19380 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $400 | $0 | $400 | 8.99% |
| PETERSON DOUGLAS C3 | 598 RIVERWOOD AVE PT PLEASANT, NJ 08742 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $72 | $0 | $72 | 1.62% |
| TROCKI GEORGE3 | 221 PROSPECT CIR SHREWSBURY, PA 17361 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $66 | $0 | $66 | 1.48% |
| SHANAMAN AMY JO3 Filed as: SHANAMAN JO | 84 MAIN ST PO BOX 71 STRAUSSTOWN, PA 19559 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $47 | $0 | $47 | 1.06% |
| KULIKAUSKA JANE3 | 3022 NESCO RD HAMMONTOWN, NJ 08037 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $11 | $0 | $11 | 0.25% |
| HIPPS CRYSTAL3 | 534 BETTY LANE COLUMBIA, PA 17512 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $607 | $0 | $607 | 17.45% |
| 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 | 8.80% |
| DAY AUBREY L3 | 3806 PINE HILL DR COLUMBIA, PA 17512 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $91 | $0 | $91 | 2.62% |
| PETERSON DOUGLAS C3 | 598 RIVERWOOD AVE PT PLEASANT, NJ 08742 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $51 | $0 | $51 | 1.47% |
| TROCKI GEORGE3 | 221 PROSPECT CIRCLE SHREWBURY, PA 17361 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $18 | $0 | $18 | 0.52% |
| KULIKAUSKAS JANE3 | 3022 NESCO RD HAMMONTON, NJ 08037 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2 | $0 | $2 | 0.06% |
| HIPPS CRYSTAL3 | 534 BETTY LANE COLUMBIA, PA 17512 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $388 | $0 | $388 | 11.21% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: ELEMENT RISK MANAGEMENT LLC | 310 N HIGH ST WEST CHESTER, PA 19380 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $153 | $0 | $153 | 4.42% |
| TROCKI GEORGE3 | 221 PROSPECT CIRCLE SHREWBURY, PA 17361 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $66 | $0 | $66 | 1.91% |
| SHANAMAN AMY JO3 | 84 MAIN ST PO BOX 71 STRAUSSTOWN, PA 19559 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $26 | $0 | $26 | 0.75% |
| DAY AUBREY L3 | 3806 PIE HILL DR COLUMBIA, PA 17512 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $24 | $0 | $24 | 0.69% |
| PETERSON DOUGLAS C3 | 598 RIVERWOOD AVE PT PLEASANT, NJ 08742 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $15 | $0 | $15 | 0.43% |
| HIPPS CRYSTAL3 | 534 BETTY LANE COLUMBIA, PA 17512 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $154 | $0 | $154 | 9.33% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: ELEMENT RISK MANAGEMENT LLC | 310 N HIGH ST WEST CHESTER, PA 19380 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $125 | $0 | $125 | 7.58% |
| TROCKI GEORGE3 | 221 PROSPECT CIRCLE SHREWSBURY, PA 17361 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $33 | $0 | $33 | 2.00% |
| PETERSON DOUGLAS C3 | 598 RIVERWOOD AVE PT PLEASANT, NJ 08742 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $16 | $0 | $16 | 0.97% |
| BRISTOL ROBERT3 | 126 HARLOW POINTE COURT LANDENBERG, PA 19350 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $9 | $0 | $9 | 0.55% |
| KALIKAUSKA JANE3 | 3022 NESCO RD HAMMONTON, NJ 08037 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3 | $0 | $3 | 0.18% |
| HIPPS CRYSTAL3 | 534 BETTY LN COLUMBIA, PA 17512 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $273 | $0 | $273 | 19.04% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: ELEMENT RISK MANAGEMENT LLC | 310 N HIGH ST WEST CHESTER, PA 19380 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $133 | $0 | $133 | 9.27% |
| TROCKI GEORGE3 | 221 PROSPECT CIRCLE SHREWBURY, PA 17361 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $16 | $0 | $16 | 1.12% |
| PETERSON DOUGLAS C3 | 598 RIVERWOOD AVE PT PLEASANT, NJ 08742 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $16 | $0 | $16 | 1.12% |
| SHANAMAN AMY JO3 | 84 MAIN ST PO BOX 71 STRAUSSTOWN, PA 19559 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $15 | $0 | $15 | 1.05% |
| KULIKAUSKAS JANE3 | 3022 NESCO RD HAMMONTON, NJ 08037 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $5 | $0 | $5 | 0.35% |
| ROLLER DAVID3 | 80 DOLPHIN CIRCLE E BAYVILLE, NJ 08721 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3 | $0 | $3 | 0.21% |
| HIPPS CRYSTAL3 | 534 BETTY LN COLUMBIA, PA 17512 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $26 | $0 | $26 | 2.71% |
| SHANAMAN AMY JO3 | 84 MAIN ST PO BOX 71 STRAUSSTOWN, PA 19559 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $21 | $0 | $21 | 2.19% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: ELEMENT RISK MANAGEMENT LLC | 310 N HIGH ST WEST CHESTER, PA 19380 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $20 | $0 | $20 | 2.08% |
| TROCKI GEORGE3 | 221 PROSPECT CIR SHREWSBURY, PA 17361 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $12 | $0 | $12 | 1.25% |
| HIPPS CRYSTAL3 | 534 BETTY LN COLUMBIA, PA 17512 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $197 | $0 | $197 | 54.72% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: ELEMENT RISK MANAGEMENT LLC | 310 N HIGH ST WEST CHESTER, PA 19380 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $85 | $0 | $85 | 23.61% |
| PETERSON DOUGLAS C3 | 598 RIVERWOOD AVE PT PLEASANT, NJ 08742 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $12 | $0 | $12 | 3.33% |
| HIPPS CRYSTAL3 | 534 BETTY LANE COLUMBIA, PA 17512 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $5 | $0 | $5 | 5.43% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: ELEMENT RISK MANAGEMENT LLC | 310 N HIGH STREET WEST CHESTER, PA 19380 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2 | $0 | $2 | 2.17% |
| KULKAUSKAS JANE3 | 3022 NESCO RD HAMMONTON, NJ 08037 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1 | $0 | $1 | 1.09% |
| PETERSON DOUGLAS C3 | 598 RIVERWOOD AVE PT PLEASANT, NJ 08742 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1 | $0 | $1 | 1.09% |
| HIPPS CRYSTAL3 | 534 BETTY LN COLUMBIA, PA 17512 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3 | $0 | $3 | 4.92% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: ELEMENT RISK MANAGEMENT LLC | 310 N HIGH ST WEST CHESTER, PA 19380 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2 | $0 | $2 | 3.28% |
| KULIKAUSKAS JANE3 | 3022 NESCO RD HAMMONTON, NJ 08037 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1 | $0 | $1 | 1.64% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE BENECON GROUP, LLC EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $3K |
| PCI (PA CHAMBER INSURANCE) EIN 25-1784573 BROKER | Insurance agents and brokers Service code 22 | — | $1K |
| CAPITAL BLUE CROSS EIN 23-0455154 ADMIN | Claims processing Service code 12 | — | -$24 |
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 | 60 | 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) | 60 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK, INC. | 73 | $579K |
| Dental | UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY | 0 | $0 |
| Vision | NATIONAL VISION ADMINISTRATOR, LLC | 0 | $0 |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY | 0 | $0 |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 0 | $84K |
| Other(13 contracts, 2 carriers) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 17 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 73 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.