| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AIA AMERICAN INS ADMINISTRATORS LLC3 Filed as: AIA AMERICAN INSURANCE ADMIN. | 4550 LENA DRIVE MECHANICSBURG, PA 17055 | HARTFORD LIFE AND ACCIDENT | $19K | $0 | $19K | 10.00% |
| JONATHON R SEELE3 Filed as: JONATHON R. SEELE | 60 BYRON NELSON CIRCLE ETTERS, PA 17319 | AFLAC | $28 | $0 | $28 | 2.77% |
| C A LUPP INC3 | 940 EAST PARK DRIVE, SUITE 301 HARRISBURG, PA 17111 | AFLAC | $17 | $0 | $17 | 1.68% |
| MJ INSURANCE3 Filed as: DEBRA L. CARL AND VARIOUS AGENTS | 2042 STATE ROUTE 61 SUNBURY, PA 17801 | AFLAC | $16 | $0 | $16 | 1.58% |
| ANTHONY S ALMODOVAR3 Filed as: ANTHONY S. ALMODOVAR | 3605 VARTAN WAY, SUITE 304 HARRISBURG, PA 17110 | AFLAC | $10 | $0 | $10 | 0.99% |
| DIANNE L MARTIN3 Filed as: DIANNE L. MARTIN | 125 MANOR STREET HARRISBURG, PA 17110 | AFLAC | $10 | $0 | $10 | 0.99% |
| C H ROBINSON & ASSOCIATES INC3 Filed as: C H ROBINSON & ASSOCIATES | 9969 NW 16TH ROAD GAINSVILLE, FL 32606 | AFLAC | $7 | $0 | $7 | 0.69% |
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | 200 INTERNATIONAL CIRCLE SUITE 4500 HUNT VALLEY, MD 21030 | AFLAC | $6 | $0 | $6 | 0.59% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAPITAL BLUE CROSS EIN 23-0455154 CLAIMS PROCESSING | Claims processing Service code 12 | — | $4.0M |
| HEALTH EQUITY INC. EIN 52-2383166 FSA CLAIMS | Other services Service code 49 | — | $293K |
| OSS HEALTH EIN 80-0458999 CLAIMS PROCESSING | Claims processing Service code 12 | — | $113K |
| LEGENDS HOLDINGS LLC EIN 82-3317025 CAPTIVE INSURANCE | Insurance services Service code 23 | — | $50K |
| ECB RX LLC EIN 45-2580354 PRESCRIPTIONS | Insurance services Service code 23 | — | $31K |
| AMERICAN INSURANCE ADMINISTRATORS EIN 25-1691584 BENEFIT SOFTWARE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $25K |
| ALIGHT SOLUTIONS EIN 82-1061233 CLAIMS PROCESSING | Claims processing Service code 12 | — | $18K |
| TELADOC HEALTH INC EIN 04-3705970 TELEMEDICINE | Insurance services Service code 23 | — | $16K |
| MCKONLY & ASBURY LLC EIN 23-1909723 ACCOUNTING & AUDIT | Accounting (including auditing) Service code 10 | — | $12K |
| MCNEES WALLACE & NURICK EIN 23-1256003 LEGAL FEES | Legal Service code 29 | — | $12K |
| ACCOLADE, INC. EIN 01-0969591 PATIENT ADVOCACY | Insurance services Service code 23 | — | $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 | 337 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 342 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CAPITAL ADVANTAGE ASSURANCE COMPANY | 323 | $198K |
| Vision | CAPITAL ADVANTAGE ASSURANCE COMPANY | 323 | $198K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 461 | $190K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 461 | $189K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 461 | $189K |
| Stop-loss / reinsurancereinsurance | SUNLIFE ASSURANCE COMPANY OF CANADA | 337 | $481K |
| Other | HARTFORD LIFE AND ACCIDENT | 461 | $189K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 461 | — |
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."
No prospect flags tripped on this filing.