| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LILLIS MCKIBBEN BONGIOVANNI & CO3 Filed as: LILLIS, MCKIBBEN, BONGIOVANNI & CO. | 100 STATE STREET, SUITE 510 ERIE, PA 16507 | HIGHMARK, INC. | $73K | — | $73K | 2.75% |
| LILLIS MCKIBBEN BONGIOVANNI & CO3 Filed as: LILLIS, MCKIBBEN, BONGIOVANNI & CO. | 100 STATE STREET, SUITE 510 ERIE, PA 16507 | DELTA DENTAL OF PENNSYLVANIA | $6K | — | $6K | 5.00% |
| LILLIS MCKIBBEN BONGIOVANNI & CO3 Filed as: LILLIS, MCKIBBEN, BONGIOVANNI & CO. | 100 STATE STREET, SUITE 510 ERIE, PA 16507 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $1K | $8K | 17.93% |
| FMLASOURCE INC5 | 455 N CITYFRONT PLZ DR, 13TH FL CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $6K | $6K | 21.31% |
| LILLIS MCKIBBEN BONGIOVANNI & CO3 Filed as: LILLIS, MCKIBBEN, BONGIOVANNI & CO. | 100 STATE STREET, SUITE 510 ERIE, PA 16507 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $738 | $4K | 12.66% |
| LILLIS MCKIBBEN BONGIOVANNI & CO3 Filed as: LILLIS, MCKIBBEN, BONGIOVANNI & CO. | 305 WEST 6TH STREET ERIE, PA 16507 | HEARTLAND | $1K | — | $1K | 8.00% |
| LILLIS MCKIBBEN BONGIOVANNI & CO3 Filed as: LILLIS, MCKIBBEN, BONGIOVANNI & CO. | 100 STATE STREET, SUITE 510 ERIE, PA 16507 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $570 | $3K | 18.16% |
| LILLIS MCKIBBEN BONGIOVANNI & CO3 Filed as: LILLIS, MCKIBBEN, BONGIOVANNI & CO. | 100 STATE STREET, SUITE 510 ERIE, PA 16507 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $466 | $3K | 17.77% |
| LILLIS MCKIBBEN BONGIOVANNI & CO3 Filed as: LILLIS, MCKIBBEN, BONGIOVANNI & CO. | 100 STATE STREET, SUITE 510 ERIE, PA 16507 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $347 | $2K | 12.91% |
| LILLIS MCKIBBEN BONGIOVANNI & CO3 Filed as: LILLIS, MCKIBBEN, BONGIOVANNI & CO. | 305 WEST 6TH STREET ERIE, PA 16507 | HEARTLAND | $111 | — | $111 | 7.97% |
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 | 283 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 285 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK, INC. | 232 | $2.7M |
| Dental | DELTA DENTAL OF PENNSYLVANIA | 237 | $118K |
| Vision(2 contracts) | HEARTLAND | 229 | $20K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 254 | $12K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 283 | $28K |
| Prescription drug | HIGHMARK, INC. | 232 | $2.7M |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 254 | $92K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 283 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.