| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE COALITION3 Filed as: INSURANCE COALITION INC | 417 WALNUT STREET HARRISBURG, PA 17101 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $804 | $0 | $804 | 3.71% |
| BENECHOICE ENROLLMENT SOLUTIONS3 | 1547 LITITZ PIKE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $627 | $34 | $661 | 3.05% |
| LANCE A BRADLEY3 | 2028 MOUNT VERNON CIR HARRISBURG, PA 17110 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $417 | $10 | $427 | 1.97% |
| PETRINA SKILES3 | 1574 LITITZ PIKE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $285 | $96 | $381 | 1.76% |
| INSURANCE COALITION3 | 417 WALNUT STREET HARRISBURG, PA 17105 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $758 | $0 | $758 | 8.82% |
| PCI INSURANCE AGENCY3 Filed as: PCI INSURANCE INC | 417 WALNUT STREET HARRISBURG, PA 17101 | DEARBORN LIFE INSURANCE COMPANY | $326 | $0 | $326 | 18.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAPITAL BLUECROSS EIN 23-0455154 ADMIN | Claims processing Service code 12 | — | $9K |
| PCI (PA CHAMBER INSURANCE) EIN 25-1784573 BROKER | Insurance agents and brokers Service code 22 | — | $7K |
| THE BENECON GROUP, LLC EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $4K |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $1K |
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 | 23 | 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) | 23 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CAPITAL ADVANTAGE ASSURANCE COMPANY | 25 | $9K |
| Vision | CAPITAL ADVANTAGE ASSURANCE COMPANY | 25 | $9K |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 23 | $2K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 12 | $22K |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 16 | $110K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 23 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 25 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.