| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE COALITION3 Filed as: INSURANCE COALITION, INC | 417 WALNUT ST HARRISBURG, PA 17101 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 14.49% |
| STRATEGIC EMPLOYEE BENEFIT SERVICES3 Filed as: STRATEGIC NON-MEDICAL SOLUTIONS | 75 STATE ST, STE 1710 BOSTON, MA 02108 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $0 | $78 | $78 | 0.81% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN BROWN OF PA INC | 125 E ELM ST STE 210 CONSHOHOCKEN, PA 19428 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $19 | $0 | $19 | 0.20% |
| INSURANCE COALITION3 Filed as: INSURANCE COALITION INC | 417 WALNUT ST HARRISBURG, PA 17101 | VISION SERVICE PLAN | $241 | $0 | $241 | 9.89% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 1787 SENTRY PKWY W BLUE BELL, PA 19422 | VISION SERVICE PLAN | $129 | $0 | $129 | 5.29% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PCI (PA CHAMBER INSURANCE) EIN 25-1784573 BROKER | Insurance agents and brokers Service code 22 | — | $11K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $10K |
| CONNECTCARE3, LLC 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 |
| CAPITAL BLUECROSS EIN 23-0455154 CARRIER | Claims processing Service code 12 | — | -$180 |
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 | 29 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 30 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF PENNSYLVANIA | 0 | $0 |
| Vision | VISION SERVICE PLAN | 24 | $2K |
| Life insurance | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 33 | $10K |
| Short-term disability | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 33 | $10K |
| Stop-loss / reinsurancereinsurance | OPTUM HEALTH (UNIMERICA INSURANCE COMPANY) | 30 | $99K |
| Other | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 33 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 33 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.