| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ENGLE-HAMBRIGHT & DAVIES, INC.3 Filed as: ENGLE-HAMBRIGHT & DAVIES INC. | 1857 WILLIAM PENN WAY LANCASTER, PA 17601 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $0 | $3K | 5.01% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICE INC | PO BOX 632886 CINCINNATI, OH 45263 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $131 | $131 | 0.26% |
| ENGLE-HAMBRIGHT & DAVIES, INC.3 Filed as: ENGLE-HAMBRIGHT & DAVIES INC. | 1857 WILLIAM PENN WAY LANCASTER, PA 17601 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $0 | $4K | 15.00% |
| ENGLE-HAMBRIGHT & DAVIES, INC.3 Filed as: ENGLE-HAMBRIGHT & DAVIES INC. | 1857 WILLIAM PENN WAY LANCASTER, PA 17601 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 15.00% |
| ENGLE-HAMBRIGHT & DAVIES, INC.3 Filed as: ENGLE-HAMBRIGHT & DAVIES INC. | 1857 WILLIAM PENN WAY LANCASTER, PA 17601 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 15.00% |
| ENGLE-HAMBRIGHT & DAVIES, INC.3 Filed as: ENGLE-HAMBRIGHT & DAVIES INC. | 1857 WILLIAM PENN WAY LANCASTER, PA 17605 | VISION BENEFITS OF AMERICA | $416 | $0 | $416 | 3.50% |
| ENGLE-HAMBRIGHT & DAVIES, INC.3 Filed as: ENGLE-HAMBRIGHT & DAVIES INC. | 1857 WILLIAM PENN WAY LANCASTER, PA 17601 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 15.00% |
| ENGLE-HAMBRIGHT & DAVIES, INC.3 Filed as: ENGLE-HAMBRIGHT & DAVIES INC. | 1857 WILLIAM PENN WAY LANCASTER, PA 17601 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $885 | $0 | $885 | 10.00% |
| ENGLE-HAMBRIGHT & DAVIES, INC.3 Filed as: ENGLE-HAMBRIGHT & DAVIES INC. | 1857 WILLIAM PENN WAY LANCASTER, PA 17601 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $492 | $0 | $492 | 10.01% |
| ENGLE-HAMBRIGHT & DAVIES, INC.3 Filed as: ENGLE-HAMBRIGHT & DAVIES INC. | 1857 WILLIAM PENN WAY LANCASTER, PA 17605 | VISION BENEFITS OF AMERICA | $134 | $0 | $134 | 8.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ENGLE HAMBRIGHT & DAVIES, INC. BROKER | Insurance agents and brokers Service code 22 | 1857 WILLIAM PENN WAY LANCASTER, PA 17601 | $35K |
| THE BENECON GROUP, LLC EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $18K |
| HIGHMARK EIN 23-1294723 ADMIN | Claims processing Service code 12 | — | $15K |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $5K |
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 | 95 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 97 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 175 | $51K |
| Vision(2 contracts) | VISION BENEFITS OF AMERICA | 85 | $14K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 67 | $12K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 66 | $21K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 29 | $24K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 79 | $251K |
| Other(5 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 95 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 175 | — |
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.