| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BSI CORPORATE BENEFITS LLC3 | 205 WEBSTER ST BETHLEHEM, PA 18015 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $9K | $9K | 0.18% |
| BSI CORPORATE BENEFITS LLC3 | 205 WEBSTER ST BETHLEHEM, PA 18015 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $9K | $9K | 0.22% |
| BSI CORPORATE BENEFITS LLC3 | 205 WEBSTER ST BETHLEHEM, PA 18015 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $182K | $9K | $191K | 6.29% |
| BSI CORPORATE BENEFITS LLC3 | 205 WEBSTER ST BETHLEHEM, PA 18015 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $9K | $9K | 0.54% |
| FMLASOURCE INC3 Filed as: FMLASOURCE INC. | 455 N CITYFRONT PLZ DR 13TH FL CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $176K | $176K | 19.37% |
| BSI CORPORATE BENEFITS LLC3 | 205 WEBSTER ST BETHLEHEM, PA 18015 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $9K | $9K | 0.96% |
| BSI CORPORATE BENEFITS LLC3 | 205 WEBSTER ST BETHLEHEM, PA 18015 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $151K | $9K | $160K | 19.04% |
| BSI CORPORATE BENEFITS LLC3 | 205 WEBSTER ST BETHLEHEM, PA 18015 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $128K | $9K | $137K | 19.23% |
| BSI CORPORATE BENEFITS LLC3 | 205 WEBSTER ST BETHLEHEM, PA 18015 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $9K | $9K | 1.35% |
| BSI CORPORATE BENEFITS LLC3 | 205 WEBSTER ST BETHLEHEM, PA 18015 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $5K | $5K | 2.89% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF SC EIN 57-0287419 ADMIN | Claims processing Service code 12 | — | $6.8M |
| UNITED CONCORDIA COMPANIES, INC. EIN 25-1687586 ADMIN | Claims processing Service code 12 | — | $651K |
| LEHIGH VALLEY BUSINESS CONF ON HEAL BROKER | Insurance agents and brokers Service code 22 | 60 WEST BROAD ST STE 302A BETHLEHEM, PA 18018 | $9K |
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 | 18,385 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 60 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 18,445 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 14,201 | $2.7M |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 18,385 | $3.9M |
| Short-term disability(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 8,444 | $7.2M |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 15,500 | $4.1M |
| Other(5 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 18,385 | $7.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 18,385 | — |
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.