| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ENGLE-HAMBRIGHT & DAVIES, INC.3 Filed as: ENGLE HAMBRIGHT & DAVIES, INC | 115 E KING STREET LANCASTER, PA 17602 | CITIZENS SECURITY LIFE INSURANCE COMPANY | $4K | $0 | $4K | 10.00% |
| ENGLE-HAMBRIGHT & DAVIES, INC.3 | 115 E KING ST. PO BOX 83080 LANCASTER, PA 17608 | SECURITY MUTUAL LIFE INSURANCE COMPANY OF NEW YORK | $3K | $0 | $3K | 17.00% |
| WHALEN INSURANCE ASSOCIATES, INC.3 | 275 HESS BLVD. PO BOX 5040 LANCASTER, PA 17602 | SECURITY MUTUAL LIFE INSURANCE COMPANY OF NEW YORK | $530 | $0 | $530 | 3.00% |
| ENGLE-HAMBRIGHT & DAVIES, INC.3 | 115 E KING ST. PO BOX 83080 LANCASTER, PA 17608 | SECURITY MUTUAL LIFE INSURANCE COMPANY OF NEW YORK | $1K | $0 | $1K | 11.43% |
| WHALEN INSURANCE ASSOCIATES, INC.3 | 275 HESS BLVD. PO BOX 5040 LANCASTER, PA 17602 | SECURITY MUTUAL LIFE INSURANCE COMPANY OF NEW YORK | $334 | $0 | $334 | 2.86% |
| ENGLE-HAMBRIGHT & DAVIES, INC.3 | 115 E KING ST. PO BOX 83080 LANCASTER, PA 17608 | SECURITY MUTUAL LIFE INSURANCE COMPANY OF NEW YORK | $2K | $0 | $2K | 17.00% |
| WHALEN INSURANCE ASSOCIATES, INC.3 | 275 HESS BLVD. PO BOX 5040 LANCASTER, PA 17602 | SECURITY MUTUAL LIFE INSURANCE COMPANY OF NEW YORK | $272 | $0 | $272 | 3.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HIGHMARK EIN 23-1294723 ADMIN | Claims processing Service code 12 | — | $64K |
| ENGLE HAMBRIGHT & DAVIES BROKER | Insurance agents and brokers Service code 22 | 115 E. KING STREET LANCASTER, PA 17602 | $33K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $21K |
| CONNECTCARE 3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $6K |
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 | 133 | 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) | 134 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CITIZENS SECURITY LIFE INSURANCE COMPANY | 72 | $36K |
| Vision | HIGHMARK | 106 | $6K |
| Life insurance | SECURITY MUTUAL LIFE INSURANCE COMPANY OF NEW YORK | 133 | $12K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | EVEREST REINSURANCE COMPANY | 106 | $306K |
| Other(3 contracts) | SECURITY MUTUAL LIFE INSURANCE COMPANY OF NEW YORK | 133 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 133 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.