| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CORPORATE SYNERGIES GROUP LLC3 | 5000 DEARBORN CIRCLE SUITE 100 MT LAUREL, NJ 08054 | AETNA LIFE INSURANCE CO. | $179 | — | $179 | 1.10% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HIGHMARK INC. EIN 23-1294723 NONE | Claims processing; Other fees Service code 12 | — | $18K |
| EHD NONE | Insurance agents and brokers Service code 22 | 1857 WILLIAM PENN WAY LANCASTER, PA 17601 | $13K |
| THE BENECON GROUP EIN 23-1315351 NONE | Insurance agents and brokers; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 13 | — | $11K |
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 | 116 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF PENNSYLVANIA | 232 | $28K |
| Vision | VISION BENEFITS OF AMERICA | 128 | $5K |
| Life insurance | AETNA LIFE INSURANCE CO. | 153 | $16K |
| Long-term disability | AETNA LIFE INSURANCE CO. | 153 | $16K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 113 | $189K |
| Other | AETNA LIFE INSURANCE CO. | 153 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 232 | — |
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.