| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SVCS USA INC | PO BOX 601478 CHARLOTTE, NC 28250 | HEALTHAMERICA OF PENNSYLVANIA, INC. | $51K | — | $51K | 2.51% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SVCS USA INC | PO BOX 601478 CHARLOTTE, NC 28250 | COVENTRY HEALTH AND LIFE | $9K | — | $9K | 2.51% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SVCS USA INC | 600 HIGHWAY 169 SOUTH ST. LOUIS PARK, MN 55426 | AETNA LIFE INSURANCE COMPANY | $26K | — | $26K | 13.88% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SVCS USA INC | PO BOX 601478 CHARLOTTE, NC 28250 | DELTA DENTAL OF PENNSYLVANIA | $4K | $24K | $28K | 21.29% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SVCS USA INC | 5151 BELT LINE RD. #200 DALLAS, TX 75254 | UNITEDHEALTHCARE INSURANCE COMPANY | $331 | — | $331 | 9.98% |
| TRANSAMERICA3 | 1400 CENTERVIEW LITTLE ROCK, AR 72211 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $166 | $166 | 5.01% |
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 | 498 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 502 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTHAMERICA OF PENNSYLVANIA, INC. | 466 | $2.4M |
| Dental | DELTA DENTAL OF PENNSYLVANIA | 692 | $134K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 28 | $3K |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 558 | $188K |
| Long-term disability | AETNA LIFE INSURANCE COMPANY | 558 | $188K |
| Other | AETNA LIFE INSURANCE COMPANY | 558 | $188K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 692 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.