| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BSI CORPORATE BENEFITS LLC3 Filed as: BSI COOPERATE BENEFITS LLC | 79 W MARKET ST STE 400 BETHLEHEM, PA 18018 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $21K | $0 | $21K | 15.00% |
| AP BENEFIT ADVISORS, LLC3 | 200 INTERNATIONAL CIRCLE, STE 4500 HUNT VALLEY, MD 21030 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 3.91% |
| BSI CORPORATE BENEFITS LLC3 Filed as: BSI COOPERATE BENEFITS LLC | 79 W MARKET ST STE 400 BETHLEHEM, PA 18018 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.70% |
| AP BENEFIT ADVISORS, LLC3 | 200 INTERNATIONAL CIRCLE, STE 4500 HUNT VALLEY, MD 21030 | VISION SERVICE PLAN | -$4 | $0 | -$4 | -0.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BSI CORPORATE BENEFITS, LLC BROKER | Insurance agents and brokers Service code 22 | 79 WEST MARKET ST STE 400 BETHLEHEM, PA 18018 | $130K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $43K |
| CAPITAL BLUE CROSS EIN 23-0455154 ADMIN | Claims processing Service code 12 | — | $19K |
| UNITED CONCORDIA COMPANIES, INC EIN 25-1687586 ADMIN | Claims processing Service code 12 | — | $16K |
| CONNECTCARE 3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $15K |
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 | 279 | 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) | 279 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 225 | $30K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 274 | $140K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 274 | $140K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 230 | $476K |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 279 | $145K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 279 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.