| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COLONIAL PARK REALTY3 | 5912 LINGLESTOWN RD HARRISBURG, PA 17112 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $199 | $0 | $199 | 0.93% |
| EMERSON REID LLC3 Filed as: EMERSON REID & CO | 1787 SENTRY PKWAY W, VEVA 16 STE 320 BLUE BELL, PA 19422 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $0 | $0 | — |
| COLONIAL PARK REALTY3 | PO BOX 6118 5912 LINGLESTOWN RD HARRISBURG, PA 17112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $0 | $0 | — |
| COLONIAL PARK REALTY3 | PO BOX 6118 5912 LINGLESTOWN RD HARRISBURG, PA 17112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $0 | $0 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAPITAL BLUE CROSS EIN 23-0455154 CARRIER | Claims processing Service code 12 | — | $2K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $1K |
| CONNECTCARE3 EIN 23-1605577 PATIENT ADVOCATE | Other services Service code 49 | — | $255 |
| ENDERS INSURANCE ASSOCIATES EIN 23-1605577 BROKER | Insurance agents and brokers Service code 22 | — | $0 |
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 | 46 | 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) | 46 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CAPITAL ADVANTAGE ASSURANCE COMPANY | 68 | $21K |
| Vision | CAPITAL ADVANTAGE ASSURANCE COMPANY | 68 | $21K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 0 | $0 |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 0 | $0 |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 0 | $0 |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 46 | $11K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 0 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 68 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.