| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMERICAN INSURANCE ADMINISTRATORS3 | UNKNOWN TIPTON, PA 16684 | HIGHMARK INC. | $25K | — | $25K | 2.38% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 116 HUNTINGTON AVENUE, 10TH FLOOR BOSTON, MA 02116 | HIGHMARK INC. | $5K | — | $5K | 0.48% |
| BROKER BENEFIT SOLUTIONS INC3 Filed as: BROKER BENEFIT SOLUTIONS, INC. | 4550 LENA DRIVE MECHANICSBURG, PA 17055 | AETNA LIFE INSURANCE COMPANY | $8K | — | $8K | 9.72% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4000 MIDLANTIC DRIVE, SUITE 350 MOUNT LAUREL, NJ 08054 | AETNA LIFE INSURANCE COMPANY | $550 | — | $550 | 0.64% |
| AMERICAN INSURANCE ADMINISTRATORS3 | 4550 LENA DRVE MECHANICSBURG, PA 17055 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 5.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 3697 MOUNT DIABLO BOULEVARD SUITE 300 LAFAYETTE, CA 94549 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $566 | — | $566 | 2.80% |
| BULFINCH GROUP INSURANCE AGENCY3 | 160 GOULD STREET, SUITE 310 NEEDHAM, MA 02494 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $11 | — | $11 | 0.05% |
| INDEPENDENCE PLANNING GROUP3 | 1767 SENTRY PARKWAY WEST BLUE BELL, PA 19422 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $6 | — | $6 | 0.03% |
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 | 173 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 173 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK INC. | 254 | $1.0M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 38 | $20K |
| Vision | HIGHMARK INC. | 254 | $1.0M |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 173 | $87K |
| Short-term disability | AETNA LIFE INSURANCE COMPANY | 173 | $87K |
| Long-term disability | AETNA LIFE INSURANCE COMPANY | 173 | $87K |
| Prescription drug | HIGHMARK INC. | 254 | $1.0M |
| Other(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 205 | $92K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 254 | — |
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.