| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PENTRA LLC3 Filed as: PENTRA INC | 795 E. LANCASTER AVE. SUITE 210 VILLANOVA, PA 190851500 | AETNA LIFE INSURANCE CO. | $0 | $144K | $144K | 3.05% |
| PENTRA LLC3 Filed as: PENTRA INC | 795 E. LANCASTER AVE. SUITE 210 VILLANOVA, PA 190851500 | AETNA LIFE INSURANCE CO. | $0 | $22K | $22K | 0.46% |
| PENTRA LLC3 Filed as: PENTRA INC | TWO VILLANOVA CENTER 795 E LANCASTER AVE STE 210 VILLANOVA, PA 19085 | DELTA DENTAL OF PENNSYLVANIA | $19K | $0 | $19K | 5.00% |
| INTEGRATED BENEFIT SERVICES INC3 | 795 E LANCASTER AVE STE 210 VILLANOVA, PA 19085 | HARTFORD LIFE AND ACCIDENT | $40K | $0 | $40K | 14.15% |
| PENTRA LLC3 Filed as: PENTRA | 795 E LANCASTER AVE STE 210 VILLANOVA, PA 19085 | HARTFORD LIFE AND ACCIDENT | $2K | $0 | $2K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LIFEWORKS U.S. INC. EIN 81-1114266 NONE | Other services; Contract Administrator; Other fees Service code 13 | 3311 E. OLD SHAKOPEE ROAD MINNEAPOLIS, MN 55425 | $7K |
| ADP, LLC NONE | Claims processing; Contract Administrator Service code 12 | ONE ADP BOULEVARD ROSELAND, NJ 07068 | $5K |
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 | 444 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 10 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 1 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 461 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 814 | $4.7M |
| Dental | DELTA DENTAL OF PENNSYLVANIA | 904 | $377K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 660 | $284K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 660 | $284K |
| Other(2 contracts) | HARTFORD LIFE AND ACCIDENT | 660 | $294K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 904 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.