| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PENNSYLVANIA | 125 E. ELM ST STE 210 CONSHOHOCKEN, PA 19428 | HIGHMARK, INC. | $4K | $0 | $4K | 20.22% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PENNSYLVANIA, INC. | 125 E ELM ST STE 210 CONSHOHOCKEN, PA 19428 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $862 | $0 | $862 | 10.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA | 11220 ASSET LOOP, STE 304 MANASSAS, VA 20109 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $83 | $83 | 0.96% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PENNSYLVANIA, INC. | 125 E ELM ST STE 210 CONSHOHOCKEN, PA 19428 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $604 | $0 | $604 | 10.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA | 11220 ASSER LOOP, STE 3014 MANASSAS, VA 20109 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $57 | $57 | 0.94% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PENNSYLVANIA, INC. | 125 E ELM ST STE 210 CONSHOHOCKEN, PA 19428 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $301 | $0 | $301 | 10.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA | 11220 ASSET LOOP, STE 304 MANASSAS, VA 20109 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $11 | $11 | 0.37% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PENNSYLVANIA, INC. | 125 E ELM ST STE 210 CONSHOHOCKEN, PA 19428 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $0 | $2K | 100.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA | 11220 ASSET LOOP, STE 304 MANASSAS, VA 20109 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $220 | $220 | 9.40% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BROWN & BROWN (PA) EIN 20-0878127 BROKER | Insurance agents and brokers Service code 22 | — | $23K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $13K |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $4K |
| CAPITAL BLUECROSS EIN 23-0455154 ADMIN | Claims processing Service code 12 | — | -$11K |
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 | 53 | 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) | 53 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | HIGHMARK, INC. | 110 | $22K |
| Vision | NATIONAL VISION ADMINISTRATORS, LLC | 0 | $742 |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $2K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $6K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $9K |
| Stop-loss / reinsurancereinsurance | OPTUM HEALTH (UNIMERICA INSURANCE COMPANY) | 53 | $314K |
| Other(3 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 110 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.