| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES | 225 N SHORE DRIVE SUITE 300 PITTSBURGH, PA 15212 | AMERITAS LIFE INSURANCE CORPORATION | $4K | — | $4K | 6.21% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES | 225 NORTH SHORE DRIVE SUITE 300 PITTSBURGH, PA 15202 | SUN LIFE ASSURANCE COMPANY OF CANADA | $200 | — | $200 | 1.11% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES | 225 N SHORE DRIVE SUITE 300 PITTSBURGH, PA 15202 | SUN LIFE ASSURANCE COMPANY OF CANADA | $80 | — | $80 | 1.77% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES | 225 N SHORE DRIVE SUITE 300 PITTSBURGH, PA 15202 | SUN LIFE ASSURANCE COMPANY OF CANADA | $39 | — | $39 | 1.14% |
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 | 153 | 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) | 154 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AMERITAS LIFE INSURANCE CORPORATION | 239 | $62K |
| Vision | AMERITAS LIFE INSURANCE CORPORATION | 239 | $62K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 153 | $18K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 153 | $3K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 21 | $5K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 132 | $134K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 239 | — |
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.