| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE BENECON GROUP3 | 201 E OREGON RD STE 100 LITITZ, PA 17543 | HIGHMARK INC | $2K | $0 | $2K | 7.45% |
| TRANGUCH,NICHOLAS FRANKLIN3 | 3911 MAULFAIR PL ALLENTOWN, PA 18103 | HIGHMARK INC | $438 | $0 | $438 | 1.83% |
| BSI CORPORATE BENEFITS LLC3 Filed as: BSI CORPORATE BENEFITS, LLC | 79 W MARKET ST STE 400 BETHLEHEM, PA 18018 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $879 | $557 | $1K | 16.33% |
| BSI CORPORATE BENEFITS LLC3 Filed as: BSI CORPORATE BENEFITS, LLC | 79 W MARKET ST STE 400 BETHLEHEM, PA 18018 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $811 | $474 | $1K | 15.85% |
| BSI CORPORATE BENEFITS LLC3 Filed as: BSI CORPORATE BENEFITS, LLC | 79 W MARKET ST STE 400 BETHLEHEM, PA 18018 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $385 | $218 | $603 | 15.68% |
| BSI CORPORATE BENEFITS LLC3 Filed as: BSI CORPORATE BENEFITS, LLC | 79 W MARKET ST STE 400 BETHLEHEM, PA 18018 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $376 | $205 | $581 | 15.45% |
| BSI CORPORATE BENEFITS LLC3 Filed as: BSI CORPORATE BENEFITS, LLC | 79 W MARKET ST STE 400 BETHLEHEM, PA 18018 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $303 | $176 | $479 | 15.78% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | PRINCIPAL | — | — | $0 | — |
| CENTRO BENEFITS RESEARCH LLC3 | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | PRINCIPAL | — | — | $0 | — |
| MICHAEL F SHANAHAN3 Filed as: MICHAEL FRANCIS SHANAHAN | 8235 FORSYTH BLVD STE 1200 ST LOUIS, MO 63105 | PRINCIPAL | — | — | $0 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BSI CORPORATE BENEFITS EIN 51-0467698 BROKER | Insurance agents and brokers Service code 22 | — | $22K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $11K |
| HY HOLDINGS INC EIN 30-0947699 CARRIER | Claims processing Service code 12 | — | $4K |
| HIGHMARK EIN 23-1294723 CARRIER | Claims processing Service code 12 | — | $3K |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $2K |
| INNOVU BROKER | Insurance agents and brokers Service code 22 | 2403 SIDNEY ST SUITE 225 PITTSBURGH, PA 15203 | $1K |
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 | 47 | 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) | 47 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | HIGHMARK INC | 35 | $24K |
| Vision | HIGHMARK INC | 35 | $24K |
| Life insurance(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 47 | $7K |
| Short-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 47 | $12K |
| Long-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 21 | $9K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 36 | $120K |
| Other(5 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 47 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 47 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.