| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 | 600 W. GERMANTOWN PIKE SUITE 171 PLYMOUTH MEETING, PA 19462 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $0 | $4K | 3.53% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INSURANCE AGENCY | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $0 | $8K | 10.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA, INC | 11220 ASSETT LOOP STE 304 MANASSAS, VA 20109 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $5K | $5K | 6.58% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INSURANCE AGENCY | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $0 | $4K | 10.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA, INC | 11220 ASSETT LOOP STE 304 MANASSAS, VA 20109 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 6.27% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES,INC. | 600 W. GERMANTOWN PIKE SUITE 171 PLYMOUTH MEETING, PA 19462 | VISION BENEFITS OF AMERICA | $2K | $0 | $2K | 5.00% |
| POWER-KUNKLE GROUP INC3 | 999 BERKSHIRE BLVD STE 160 WYOMISSING, PA 19610 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $368 | $2K | 12.39% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INSURANCE AGENCY | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 10.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA INC | 11220 ASSETT LOOP STE 304 SUITE 160 MANASSAS, VA 20109 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $925 | $925 | 6.88% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INSURANCE AGENCY | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $966 | $0 | $966 | 10.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA INC | 11220 ASSETT LOOP STE 3004 SUITE 160 MANASSAS, VA 20109 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $638 | $638 | 6.61% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $329 | $0 | $329 | 10.82% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BROWN & BROWN OF PA EIN 20-0878127 BROKER | Insurance agents and brokers Service code 22 | — | $55K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $47K |
| CONNECTCARE 3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $16K |
| HIGHMARK EIN 23-1294723 ADMIN | Claims processing Service code 12 | — | $1K |
| POWER-KUNKLE GROUP INC BROKER | Insurance agents and brokers Service code 22 | 999 BERKSHIRE BLVD WYOMISSING, PA 19610 | $232 |
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 | 397 | 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) | 402 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 254 | $118K |
| Vision | VISION BENEFITS OF AMERICA | 273 | $31K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 397 | $10K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 397 | $82K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 36 | $13K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 298 | $902K |
| Other(4 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 397 | $64K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 397 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.