| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SO. 8TH ST., STE. 700 MINNEAPOLIS, MN 55402 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $16K | $600 | $17K | 2.69% |
| TRIBEN INSURANCE SOLUTIONS INC3 Filed as: TRIBEN INSURANCE SOLUTIONS INC. | 200 W BALTIMORE AVE. MEDIA, PA 19063 | AETNA LIFE INSURANCE COMPANY | $8K | $6K | $14K | 10.77% |
| SPECIAL RISK INSURANCE SERVICES INC3 Filed as: SPECIAL RISK INSURANCE SERVICES, IN | PO BOX 1108 VOORHEES, NJ 08043 | AETNA LIFE INSURANCE COMPANY | $8K | — | $8K | 6.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 283 DILLSBURG, PA 17019 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $139 | $4K | 8.64% |
| T NASH SKILES INC3 Filed as: T NASH SKILES INC. | 1574 LITITZ PIKE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $2K | $4K | 8.60% |
| BENECHOICE ENROLLMENT SOLUTIONS3 Filed as: BENECHOICE ENROLLMENT SOLUTIONS INC | 1574 LITITZ PIKE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $1K | $2K | 4.38% |
| JASON RYAN LOWREY3 | 527 N OAK STREET LITITZ, PA 17543 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $728 | $159 | $887 | 1.79% |
| LANCE A BRADLEY3 | 2028 MOUNT VERNON CIR. HARRISBURG, PA 17110 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $512 | $21 | $533 | 1.08% |
| CASEY H EBBERT3 | 1574 LITITZ PIKE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $479 | $25 | $504 | 1.02% |
| BRENDA H BRIDGES3 Filed as: BRENDA LEE PLACKO | 1863 CREEK RD. MANHEIM, PA 17545 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $396 | $17 | $413 | 0.83% |
| DAVID R HEYDT3 | 3252 STAUNTON AVE. DOVER, PA 17315 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $365 | — | $365 | 0.74% |
| KATHRYON BURNSIDE3 | 219 HILLSIDE 2 DALLAS, PA 18612 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $284 | $1 | $285 | 0.58% |
| JAMES BARTLETT LLC3 Filed as: JAMES BARTLETT | 3138 GREENRIDGE DRIVE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $230 | $49 | $279 | 0.56% |
| ASHLY ELCOCK3 | 200 TATTLETOWN RD. AARONSBURG, PA 16820 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $146 | $7 | $153 | 0.31% |
| THOMAS F HAYES3 | 2205 OREGON PIKE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $137 | $7 | $144 | 0.29% |
| SPECIAL RISK INSURANCE SERVICES INC3 | PO BOX 1108 VOORHEES, NJ 08043 | DELTA DENTAL OF PENNSYLVANIA | $2K | — | $2K | 3.75% |
| TRIBEN INSURANCE SOLUTIONS INC3 Filed as: TRIBEN INSURANCE SOLUTIONS, INC. | 24 E. 2ND ST., 1ST FLOOR MEDIA, PA 19063 | DELTA DENTAL OF PENNSYLVANIA | $2K | — | $2K | 3.75% |
No Schedule C service providers reported on this filing.
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 | 315 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 316 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CAPITAL ADVANTAGE ASSURANCE COMPANY | 157 | $669K |
| Dental | DELTA DENTAL OF PENNSYLVANIA | 186 | $48K |
| Vision | CAPITAL ADVANTAGE ASSURANCE COMPANY | 157 | $620K |
| Life insurance(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 315 | $180K |
| Short-term disability | AETNA LIFE INSURANCE COMPANY | 315 | $131K |
| Long-term disability | AETNA LIFE INSURANCE COMPANY | 315 | $131K |
| Prescription drug | CAPITAL ADVANTAGE ASSURANCE COMPANY | 157 | $620K |
| Other(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 315 | $180K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 315 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.