| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: GUNN MOWERY LLC | — | DELTA DENTAL OF PENNSYLVANIA | $2K | $0 | $2K | 10.00% |
| ASSUREDPARTNERS3 Filed as: GUNN-MOWERY LLC | 650 N 12TH ST LEMOYNE, PA 17043 | STANDARD INSURANCE COMPANY | $2K | $0 | $2K | 12.00% |
| ASSUREDPARTNERS3 Filed as: GUNN-MOWERY, LLC | 650 NORTH 12TH ST LEMOYNE, PA 17043 | STANDARD INSURANCE COMPANY | $647 | $0 | $647 | 12.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE BENECON GROUP LLC EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $14K |
| GUNN MOWERY, LLC EIN 81-0587373 BROKER | Insurance agents and brokers Service code 22 | — | $12K |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $2K |
| REVIVEHEALTH, INC. EIN 86-1279290 ADMIN | Claims processing Service code 12 | — | $780 |
| HIGHMARK BLUE SHIELD (CENTRAL) EIN 23-1294723 ADMIN | Claims processing Service code 12 | — | -$279 |
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 | 32 | 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) | 32 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF PENNSYLVANIA | 44 | $15K |
| Vision | HIGHMARK INC | 40 | $3K |
| Life insurance | STANDARD INSURANCE COMPANY | 55 | $5K |
| Short-term disability | STANDARD INSURANCE COMPANY | 55 | $13K |
| Stop-loss / reinsurancereinsurance | AVALON INSURANCE COMPANY | 29 | $213K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 55 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.