| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WEVODAU INS. & BENEFIT STRATEGIES3 Filed as: WEVODAU INSURANCE & BENEFITS | 600 N FRONT ST WORMLEYSBURG, PA 17043 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 14.96% |
| PCI INSURANCE AGENCY3 Filed as: PCI INSURANCE INC | 417 WALNUT STREET HARRISBURG, PA 17101 | UNITED CONCORDIA INSURANCE COMPANY | $322 | $2 | $324 | 10.33% |
| PCI INSURANCE AGENCY3 Filed as: PCI INSURANCE INC | 417 WALNUT STREET HARRISBURG, PA 17101 | HIGHMARK | $34 | $0 | $34 | 6.05% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PCI INSURANCE AGENCY EIN 25-1784573 BROKER | Insurance agents and brokers Service code 22 | — | $2K |
| CAPITAL BLUE CROSS EIN 23-0455154 ADMIN | Claims processing Service code 12 | — | $1K |
| THE BENECON GROUP, LLC EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $881 |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $245 |
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 | 61 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 61 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 50 | $3K |
| Vision | HIGHMARK | 51 | $562 |
| Life insurance | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 61 | $39K |
| Short-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 61 | $39K |
| Long-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 61 | $39K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 48 | $16K |
| Other | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 61 | $39K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 61 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.