| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VINCENT P CASANOVA3 | 4021 REDWING LN AUDOBON, PA 19403 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $16K | $0 | $16K | 18.00% |
| VINCENT P CASANOVA3 | 4021 REDWING LN AUDOBON, PA 19403 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $0 | $9K | 18.00% |
| VINCENT P CASANOVA3 | 4021 REDWING LN AUDOBNON, PA 19403 | VISION BENEFITS OF AMERICA | $968 | $0 | $968 | 5.00% |
| VINCENT P CASANOVA3 | 4021 REDWING LN AUDOBON, PA 19403 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CORESOURCE, INC EIN 35-1846036 ADMIN | Plan Administrator; Claims processing; Other services Service code 12 | — | $131K |
| AETNA - PPO EIN 06-6033492 ADMIN | Other services; Claims processing Service code 12 | — | $39K |
| CHANGE HEALTHCARE EIN 20-5716594 ADMIN | Other services; Claims processing Service code 12 | — | $31K |
| ACS - A XEROX COMPANY EIN 36-4129784 ADMIN | Other services; Claims processing Service code 12 | — | $6K |
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 | 312 | 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) | 315 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF PENNSYLVANIA | 613 | $201K |
| Vision | VISION BENEFITS OF AMERICA | 321 | $19K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 312 | $86K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 312 | $86K |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 312 | $153K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 613 | — |
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.