| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMERICAN INSURANCE ADMIN., INC.3 Filed as: AMERICAN INSURANCE ADMIN. LLC | 4550 LENA DRIVE MECHANICSBURG, PA 17055 | UNITED CONCORDIA INSURANCE COMPANY | $16K | $3K | $20K | 12.02% |
| AIA AMERICAN INS ADMINISTRATORS LLC3 Filed as: AIA AMERICAN INSURANCE ADMIN. LLC | 4550 LENA DRIVE MECHANICSBURG, PA 17055 | HARTFORD LIFE AND ACCIDENT | $16K | $0 | $16K | 10.00% |
| GCG FINANCIAL LLC3 Filed as: AIA ALERA GROUP | 4550 LENA DRIVE MECHANICSBURG, PA 17055 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $3K | $0 | $3K | 10.10% |
| JONATHON R SEELE3 Filed as: JONATHON R. SEELE | 60 BYRON NELSON CIRCLE ETTERS, PA 17319 | AFLAC | $28 | $0 | $28 | 3.24% |
| C A LUPP INC3 | 5010 EAST TRINDLE ROAD SUITE 201 MECHANICSBURG, PA 17050 | AFLAC | $17 | $0 | $17 | 1.97% |
| ANTHONY S ALMODOVAR3 Filed as: ANTHONY S. ALMODOVAR | 3605 VARTAN WAY, SUITE 304 HARRISBURG, PA 17110 | AFLAC | $10 | $0 | $10 | 1.16% |
| DIANNE L MARTIN3 Filed as: DIANNE L. MARTIN | 125 MANOR STREET HARRISBURG, PA 17110 | AFLAC | $10 | $0 | $10 | 1.16% |
| C H ROBINSON & ASSOCIATES INC3 Filed as: CH ROBINSON & ASSOCIATES INC | 9969 NORTHWEST 16TH ROAD GAINESVILLE, FL 32606 | AFLAC | $7 | $0 | $7 | 0.81% |
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | 10 NORTH PARK DRIVE, SUITE 200 COCKEYSVILLE, MD 21030 | AFLAC | $6 | $0 | $6 | 0.69% |
| MJ INSURANCE3 Filed as: MATTHEW G. BERGER & VARIOUS AGENTS | 22 SUNNYRIDGE ROAD PHILADELPHIA, PA 19125 | AFLAC | $6 | $0 | $6 | 0.69% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHNOW ADMINISTRATIVE SERVICES EIN 11-3667763 CLAIMS PROCESSING | Claims processing Service code 12 | — | $3.2M |
| CAPITAL BLUE CROSS EIN 23-0455154 CLAIMS PROCESSING | Claims processing Service code 12 | — | $333K |
| HEALTH EQUITY INC. EIN 52-2383166 FSA CLAIMS | Other services Service code 49 | — | $278K |
| OSS HEALTH EIN 80-0458999 CLAIMS PROCESSING | Claims processing Service code 12 | — | $142K |
| ACCOLADE, INC. EIN 01-0969591 PATIENT ADVOCACY | Insurance services Service code 23 | — | $58K |
| EPLS, LLC EIN 84-1955995 PRESCRIPTIONS | Insurance services Service code 23 | — | $28K |
| RX HELP CENTERS, LLC EIN 46-2125122 RX CLAIMS PROCESSING | Claims processing Service code 12 | — | $24K |
| AMERICAN INSURANCE ADMINISTRATORS EIN 25-1691584 BENEFIT SOFTWARE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $23K |
| MCKONLEY & ASBURY LLC EIN 23-1909723 ACCOUNTING & AUDIT | Accounting (including auditing) Service code 10 | — | $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 | 302 | 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) | 307 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 597 | $162K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 563 | $34K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 421 | $163K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 421 | $162K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 421 | $162K |
| Stop-loss / reinsurancereinsurance | SUNLIFE ASSURANCE COMPANY OF CANADA | 344 | $485K |
| Other | HARTFORD LIFE AND ACCIDENT | 421 | $162K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 597 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.