| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BSI CORPORATE BENEFITS LLC3 | 79 WEST MARKET ST SUITE 400 BETHLEHEM, PA 18018 | HARTFORD LIFE AND ACCIDENT | $12K | $0 | $12K | 4.37% |
| ROB VEST4 | 280 BLUE BEND ROAD ROCKY MOUNT, VA 24151 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | — | — | $0 | — |
| STEVE VAN KOUTEREN4 | 551 LENA CIR APT 407 FOGELSVILLE, PA 18051 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | — | — | $0 | — |
| STHEALTH BENEFIT SOLUTIONS LLC3 | 18940 NORTH PIMA RD STE 210 SCOTTSDALE, AZ 85260 | SYMETRA LIFE INSURANCE COMPANY | — | — | $0 | — |
| JAMES A RUSH3 Filed as: JAMES A. RUSH | 2118 GRUVER AVE EASTON, PA 18045 | AFLAC | — | — | $0 | — |
| HUGHEY W HAUGHNEY3 | 1371 OAK DR MACUNGIE, PA 18062 | AFLAC | — | — | $0 | — |
| EDWARD F MROWKA JR3 | 5106 TIMBER LN SCHNECKSVILLE, PA 18078 | AFLAC | — | — | $0 | — |
| JUSTIN P ABRAHAM3 | 3841 HIGHPOINT DR ALLENTOWN, PA 18103 | AFLAC | — | — | $0 | — |
| EDWARD T SAWICKI3 | 3832 LINDEN ST ALLENTOWN, PA 18104 | AFLAC | — | — | $0 | — |
| JOSEPH B MCGINTY JR3 Filed as: JOSEPH B MCGINTY | 2202 CROSS CREEK ROAD MACUNGIE, PA 18062 | AFLAC | — | — | $0 | — |
| JACQUELINE M EBERZ3 | 98 LAMP POST RD NEW BRITAIN, PA 18901 | AFLAC | — | — | $0 | — |
| BSI CORPORATE BENEFITS LLC3 Filed as: BSI CORPORATE BENEFITS, LLC | 28411 NORTHWESTERN HWY STE 310 SOUTHFIELD, MI 48034 | AFLAC | $0 | — | $0 | — |
| STEPHEN D BISSELL3 | 5465 AMANDA DRIVE LAURYS STATION, PA 18059 | AFLAC | $0 | — | $0 | — |
| DELMAS R BUTLER JR3 | 46 S TULPEHOCKEN ST PINE GROVE, PA 17963 | AFLAC | $0 | — | $0 | — |
| JAMES ELDER BROOKS3 | 101 COPPER BEECH LANE WOMELSDORF, PA 19567 | AFLAC | $0 | — | $0 | — |
| MATTHEW G BERGER3 | 22 SUNNYRIDGE ROAD PHILADELPHIA, PA 19125 | AFLAC | $0 | — | $0 | — |
| NORMAN PINHAS3 | 2A LONGSTREET RD MONROE TOWNSHIP, NJ 08831 | AFLAC | $0 | — | $0 | — |
| SUMMER L JESS3 | 4129 PENN AVE APT C READING, PA 19608 | AFLAC | $0 | — | $0 | — |
| DENTON E QUICK3 | 2202 WELLINTON BLVD WYOMISSING, PA 19610 | AFLAC | $0 | — | $0 | — |
| IRENE E BROOKS3 | 101 COPPER BEECH LANE WOMELSDORF, PA 19567 | AFLAC | $0 | — | $0 | — |
| TARA MICHELLE D AGOSTINO3 | 87A BOORAEM AVE JERSEY CITY, NJ 07307 | AFLAC | $0 | — | $0 | — |
| RYAN K GOLDBERG3 | 103 CHURCH STREET #3 PHILADELPHIA, PA 19106 | AFLAC | $0 | — | $0 | — |
| JOSHUA PAUL GROUP INC3 | 17 OAK LANE RANDOLPH, NJ 07869 | AFLAC | $0 | — | $0 | — |
| DARREN D RIDDLE3 | 7850 AVONDALE TER HARRISBURG, PA 17112 | AFLAC | $0 | — | $0 | — |
| ANGELA MASSARELLI3 | 30 WATERFRONT WAY HAMMONTON, NJ 08037 | AFLAC | $0 | — | $0 | — |
| DIANNE L MARTIN3 | 2230 CAROLINE LN HARRISBURG, PA 17110 | AFLAC | $0 | — | $0 | — |
| ROBERT C. BRENTARI3 Filed as: ROBERT C BRENTARI | 2 PRINCESS ROAD LAWERENCEVILLE, NJ 08648 | AFLAC | $0 | — | $0 | — |
| CHRISTOPHER A LUPP3 | 5010 E TRINDLE ROAD STE 201 MECHANICSBURG, PA 17050 | AFLAC | $0 | — | $0 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HIGHMARK EIN 23-1294723 ADMIN | Claims processing Service code 12 | — | $506K |
| UNITED CONCORDIA COMPANIES, INC. EIN 25-1687586 ADMIN | Claims processing Service code 12 | — | $21K |
| GEISINGER EIN 23-2311553 ADMIN | Claims processing Service code 12 | — | $0 |
| JANUS ASSOCIATES EIN 52-1306404 ADMIN | Claims processing Service code 12 | — | $0 |
| UNUM EIN 01-0278678 ADMIN | Claims processing Service code 12 | — | $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 | 616 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 621 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION BENEFITS OF AMERICA | 330 | $13K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 616 | $278K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 616 | $278K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 616 | $278K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 0 | $0 |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 616 | $278K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 616 | — |
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.