| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VARNEY & COMPANY BENEFITS ADVISORS3 Filed as: L.R. WEBBER ASSOCIATES, INC. | PO BOX 593 HOLLIDAYSBURG, PA 16648 | DELTA DENTAL | $8K | — | $8K | 5.00% |
| VARNEY & COMPANY BENEFITS ADVISORS3 Filed as: L.R. WEBBER ASSOCIATES, INC. | PO BOX 593 HOLLIDAYSBURG, PA 16648 | NATIONAL VISION ADMINISTRATORS, LLC. | $1K | — | $1K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HM LIFE INSURANCE COMPANY NONE | Insurance services Service code 23 | FIFTH AVENUE PLACE 120 FIFTH AVENUE PITTSBURGH, PA 15222 | $473K |
| HIGHMARK BLUE SHIELD EIN 23-1294723 NONE | Claims processing Service code 12 | — | $128K |
| L.R. WEBBER ASSOCIATES EIN 25-1301205 NONE | Insurance agents and brokers Service code 22 | — | $32K |
| THE BENECON GROUP, INC. EIN 23-1315351 NONE | Insurance agents and brokers Service code 22 | — | $16K |
| PBASC EIN 26-3958502 NONE | Plan Administrator Service code 14 | — | $10K |
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 | 222 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 225 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL | 228 | $166K |
| Vision | NATIONAL VISION ADMINISTRATORS, LLC. | 222 | $29K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 228 | — |
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."
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.