| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVEVIC BENEFIT CONSULTANTS, INC.3 | 902 SOUTH CENTER STREET PO BOX 976 GROVE CITY, PA 16127 | UPMC HEALTH OPTIONS | $35K | — | $35K | 3.65% |
| DAVEVIC BENEFIT CONSULTANTS, INC.3 | 902 S CENTER STREET PO BOX 976 GROVE CITY, PA 16127 | HARTFORD LIFE AND ACCIDENT | $5K | — | $5K | 4.57% |
| DIGIT INSURANCE INC.3 | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | HARTFORD LIFE AND ACCIDENT | $4K | $575 | $4K | 4.13% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF PA, LLC | 1301 GRANDVIEW AVE STE 400 PITTSBURGH, PA 15211 | HARTFORD LIFE AND ACCIDENT | $507 | — | $507 | 0.50% |
| EXPRESSLINK GENERAL AGENCY LLC3 Filed as: EXPRESSLINK GENERAL AGENCY | 4200 ROCKSIDE ROAD STE 103 INDEPENDENCE, OH 44131 | HARTFORD LIFE AND ACCIDENT | — | $405 | $405 | 0.40% |
| EXPRESSLINK GENERAL AGENCY LLC3 Filed as: EXPRESSLINK GENERAL AGENCY, LLC | 4200 ROCKSIDE ROAD STE 103 CLEVELAND, OH 44131 | UNION SECURITY INSURANCE COMPANY | — | $3K | $3K | 4.53% |
| DAVEVIC BENEFIT CONSULTANTS, INC.3 | 902 S CENTER STREET PO BOX 976 GROVE CITY, PA 16127 | UNION SECURITY INSURANCE COMPANY | $2K | — | $2K | 3.49% |
| TOMORROWS EMPLOYMENT CONCEPTS LLC3 | 180 SWINDERMAN ROAD SUITE 200 WEXFORD, PA 15090 | UNION SECURITY INSURANCE COMPANY | $870 | — | $870 | 1.42% |
| DAVEVIC BENEFIT CONSULTANTS, INC.3 | 902 S CENTER STREET PO BOX 976 GROVE CITY, PA 16127 | VISION BENEFITS OF AMERICA | $634 | — | $634 | 4.58% |
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 | 112 | 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) | 112 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UPMC HEALTH OPTIONS | 250 | $957K |
| Dental | UNION SECURITY INSURANCE COMPANY | 98 | $61K |
| Vision | VISION BENEFITS OF AMERICA | 100 | $14K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 112 | $102K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 112 | $102K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 112 | $102K |
| Prescription drug | UPMC HEALTH OPTIONS | 250 | $957K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 250 | — |
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.