| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CONSOLIDATED BENEFITS INC3 | DEPT 774232 2500 ELMERTON AVE HARRISBURG, PA 17177 | FORT DEARBORN LIFE INSURANCE COMPANY | $168 | $162 | $330 | 9.79% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAPITAL ADVANTAGE ASSURANCE COMPANY EIN 45-5492167 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 2500 ELMERTON AVE HARRISBURG, PA 17177 | $83K |
| CAPITAL ADVANTAGE INSURANCE COMPANY EIN 23-2195219 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 2500 ELMERTON AVE HARRISBURG, PA 17177 | $54K |
| NATIONAL VISION ADMINISTRATORS EIN 23-3805533 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 1200 ROUTE 46 WEST CLIFTON, NJ 07013 | $48 |
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 | 470 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 470 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | FORT DEARBORN LIFE INSURANCE COMPANY | 16 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 16 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.