| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HARTMAN EMPLOYEE BENEFITS3 | 420 WILLIAM STREET WILLIAMSPORT, PA 17701 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $12K | — | $12K | 1.66% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | ONE INTERNATIONAL PLAZA 4TH FLOOR PHILADELPHIA, PA 19113 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $3K | — | $3K | 0.34% |
| HARTMAN EMPLOYEE BENEFITS3 | 420 WILLIAM STREET WILLIAMSPORT, PA 17701 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $2K | — | $2K | 1.64% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | ONE INTERNATIONAL PLAZA 4TH FLOOR PHILADELPHIA, PA 19113 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $480 | — | $480 | 0.34% |
| PURDY INSURANCE AGENCY INC3 | 136 MARKET ST PO BOX 747 SUNBURY, PA 17801 | AETNA LIFE INSURANCE CO. | $701 | — | $701 | 11.89% |
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 | 120 | 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) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CAPITAL ADVANTAGE ASSURANCE COMPANY | 100 | $734K |
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 107 | $22K |
| Life insurance | AETNA LIFE INSURANCE CO. | 120 | $6K |
| Prescription drug | CAPITAL ADVANTAGE ASSURANCE COMPANY | 100 | $142K |
| Other | AETNA LIFE INSURANCE CO. | 120 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 120 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.