| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FIRST COMMONWEALTH INSURANCE AGENCY3 | 654 PHILADELPHIA ST. INDIANA, PA 15701 | UNITEDHEALTHCARE INSURANCE COMPANY | $36K | — | $36K | 4.01% |
| FIRST COMMONWEALTH INSURANCE AGENCY3 | 654 PHILADELPHIA ST. INDIANA, PA 15701 | UNITEDHEALTHCARE INSURANCE COMPANY | $28K | — | $28K | 4.02% |
| FIRST COMMONWEALTH INS AGCY INC3 Filed as: FIRST COMMONWEALTH INSURANCE | 654 PHILADELPHIA ST. INDIANA, PA 15701 | PRINCIPAL LIFE INSURANCE COMPANY | $7K | — | $7K | 7.15% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC. | 225 WIRELESS BLVD. HAUPPAUGE, NY 11788 | PRINCIPAL LIFE INSURANCE COMPANY | — | $4K | $4K | 4.43% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 1787 SENTRY PARKWAY W. STE 320 BLUE BELL, PA 19422 | PRINCIPAL LIFE INSURANCE COMPANY | — | $425 | $425 | 0.46% |
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 | 167 | 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) | 168 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | UNITEDHEALTHCARE INSURANCE COMPANY | 212 | $1.6M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 208 | $92K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 208 | $92K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 208 | $92K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 212 | — |
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.