| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PA | 601 WALNUT STREET SUITE 805 PHILADELPHIA, PA 19106 | MADISON NATIONAL LIFE INSURANCE COMPANY | $4K | $0 | $4K | 17.28% |
| NORTH AMERICAN BENEFITS COMPANY3 | 20 VALLEY STREAM PARKWAY SUITE 310 MALVERN, PA 19355 | MADISON NATIONAL LIFE INSURANCE COMPANY | $0 | $1K | $1K | 6.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PA | 125 E ELM STREET SUITE 210 CONSHOHOCKEN, PA 19428 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $946 | $0 | $946 | 7.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PA | 125 E ELM STREET SUITE 210 CONSHOHOCKEN, PA 19428 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $72 | $0 | $72 | 6.97% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CORESOURCE, INC. EIN 35-1846036 ADMIN | Other services; Plan Administrator; Claims processing Service code 12 | — | $60K |
| ALPHA BENEFITS GROUP EIN 23-2356461 BROKER | Insurance agents and brokers; Consulting (general) Service code 16 | — | $34K |
| DELTA DENTAL OF PENNSYLVANIA EIN 23-1667011 ADMIN | Claims processing Service code 12 | — | $8K |
| ACS - A XEROX COMPANY EIN 36-4129784 ADMIN | Claims processing; Other services Service code 12 | — | $6K |
| HEALTH FITNESS EIN 41-1580506 ADMIN | 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 | 180 | 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) | 180 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $14K |
| Short-term disability | MADISON NATIONAL LIFE INSURANCE COMPANY | 36 | $22K |
| Stop-loss / reinsurancereinsurance | GERBER LIFE INSURANCE COMPANY | 0 | $241K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $1K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 36 | — |
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.