| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SPECIAL RISK INSURANCE SERVICES INC3 Filed as: SPECIAL RISK INSURANCE | PO BOX 1108 VOORHEES, NJ 08043 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $37K | — | $37K | 10.00% |
| PENTRA LLC3 Filed as: PENTRA, INC AKA INTEGRATED BEN SVCS | 795 E. LANCASTER AVE., SUITE 210 VILLANOVA, PA 19085 | EYEMED VISION CARE ON BEHALF OF THE COMBINED INSURANCE CO OF AMERICA | $7K | — | $7K | 4.90% |
| BRIAN D SCHRECK3 Filed as: BRIAN D. SCHRECK | 5940 EAST CENTRAL WICHITA, KS 67208 | UNUM LIFE INSURANCE COMPANY | $5K | — | $5K | 4.39% |
| PENTRA LLC3 Filed as: PENTRA, INC AKA INTEGRATED BEN SVCS | 795 E. LANCASTER AVE., SUITE 210 VILLANOVA, PA 19085 | METROPOLITAN LIFE INSURANCE COMPANY | $18K | $2K | $19K | 20.76% |
| PENTRA LLC3 Filed as: PENTRA, INC AKA INTEGRATED BEN SVCS | 795 E. LANCASTER AVE., SUITE 210 VILLANOVA, PA 19085 | METROPOLITAN LIFE INSURANCE COMPANY | $17K | $2K | $18K | 20.86% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | 1 PIEDMONT CTR NE, STE 600 ATLANTA, GA 303051501 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $80 | $2K | 4.06% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $775K |
| DELTA DENTAL OF PENNSYLVANIA EIN 23-1667011 CONTRACT ADMINISTRATOR | Claims processing; Participant communication; Contract Administrator; Direct payment from the plan Service code 12 | — | $117K |
| CIGNA BEHAVIORAL HEALTH, INC EIN 41-1648670 CONTRACT ADMINISTRATOR | Direct payment from the plan; Contract Administrator; Claims processing; Participant communication Service code 12 | — | $19K |
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 | 1,798 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,798 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 803 | $181K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE COMBINED INSURANCE CO OF AMERICA | 2,275 | $142K |
| Life insurance(3 contracts, 3 carriers) | PENN MUTUAL LIFE INSURANCE COMPANY | 1,417 | $706K |
| Long-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,045 | $492K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,275 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.