| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HOCKLEY & ODONNELL FINANCIAL3 | 55 SEMINARY AVE GETTYSBURG, PA 17325 | UNION SECURITY INSURANCE COMPANY | $8K | $67 | $8K | 11.93% |
| HOCKLEY & ODONNELL FINANCIAL3 | PO BOX 3039 GETTYSBURG, PA 17325 | UNION SECURITY INSURANCE COMPANY | $5K | $16 | $5K | 14.97% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PHOENIX ADMIN./PERFORMANCE HEALTH EIN 47-4998645 ADMIN | Claims processing Service code 12 | — | $86K |
| HOCKLEY & O'DONNELL EIN 23-2877377 BROKER | Insurance agents and brokers Service code 22 | — | $64K |
| S&S HEALTHCARE EIN 31-1418743 PROVIDER NETWORK | Contract Administrator Service code 13 | — | $33K |
| CAPITAL ADVANTAGE ASSURANCE COMPANY EIN 45-5492167 ADMIN | Claims processing Service code 12 | — | $11K |
| DELPHI OF FLORIDA EIN 01-0580124 PRECERTIFICATION | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $7K |
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 | 182 | 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) | 182 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | CAPITAL ADVANTAGE ASSURANCE COMPANY | 171 | $9K |
| Life insurance | UNION SECURITY INSURANCE COMPANY | 138 | $32K |
| Short-term disability | UNION SECURITY INSURANCE COMPANY | 99 | $66K |
| Long-term disability | UNION SECURITY INSURANCE COMPANY | 99 | $66K |
| Stop-loss / reinsurancereinsurance | US FIRE INSURANCE COMPANY | 0 | $183K |
| Other(2 contracts) | UNION SECURITY INSURANCE COMPANY | 138 | $98K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 171 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.