| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFIT CONNECTIONS, INC.3 Filed as: BENEFIT CONNECTIONS INC. | 43 EASTGATE DR STE 100 CARLISLE, PA 17015 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | $0 | $1K | 7.88% |
| BENEFIT CONNECTIONS, INC.3 Filed as: BENEFIT CONNECTIONS INC. | 43 EASTGATE DR STE 100 CARLISLE, PA 17015 | PRINCIPAL LIFE INSURANCE COMPANY | $413 | $0 | $413 | 12.00% |
| BENEFIT CONNECTIONS, INC.3 | 43 EASTGATE DR, STE 100 CARLISLE, PA 17015 | NATIONAL VISION ADMINISTRATORS LLC | $333 | $0 | $333 | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENEFIT CONNECTIONS EIN 20-2077105 BROKER | Insurance agents and brokers Service code 22 | — | $12K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $11K |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $2K |
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 | 42 | 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) | 42 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 39 | $16K |
| Vision | NATIONAL VISION ADMINISTRATORS LLC | 37 | $3K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 57 | $3K |
| Short-term disability | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 0 | $0 |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 42 | $134K |
| Other | AFLAC (CONTINENTAL AMERICAN INSURANCE COMPANY) | 0 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 57 | — |
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.