| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ENGLE-HAMBRIGHT & DAVIES, INC.3 Filed as: ENGLE HAMBRIGHT & DAVIES, INC. | 1857 WILLIAM PENN WAY LANCASTER, PA 17605 | SUN LIFE ASSURANCE COMPANY OF CANADA | $7K | $0 | $7K | 12.20% |
| AIA AMERICAN INS ADMINISTRATORS LLC3 Filed as: AIA AMERICAN INSURANCE ASDMINISTATO | 4550 LENA DR MECHANICSBURG, PA 17055 | SUN LIFE ASSURANCE COMPANY OF CANADA | $177 | $0 | $177 | 0.32% |
| MICHAEL A ALFONSO3 Filed as: MICHAEL ALFONSO | 2563 MARIETTA AVE LANCASTER, PA 17601 | SUN LIFE ASSURANCE COMPANY OF CANADA | $119 | $0 | $119 | 0.21% |
| ENGLE-HAMBRIGHT & DAVIES, INC.3 Filed as: ENGLE-HAMBRIGHT & DAVIES | P.O. BOX 83080 LANCASTER, PA 17605 | NATIONWIDE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 9.07% |
| AMERICAN INSURANCE ADMINISTRATORS3 | 4550 LENA DR MECHANICSBURG, PA 17055 | NATIONWIDE LIFE INSURANCE COMPANY | $173 | $0 | $173 | 1.46% |
| TRILOGY GROUP BENEFITS LLC3 Filed as: TRILOGY GROUP BENEFITS, LLC | 118 MERCHANT AVE MOUNT JOY, PA 17552 | NATIONWIDE LIFE INSURANCE COMPANY | $5 | $0 | $5 | 0.04% |
| ENGLE-HAMBRIGHT & DAVIES, INC.3 Filed as: ENGLE HAMBRIGHT & DAVIES, INC. | 1857 WILLIAM PENN WAY LANCASTER, PA 17605 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $823 | $0 | $823 | 10.00% |
| ENGLE-HAMBRIGHT & DAVIES, INC.3 Filed as: ENGLE HAMBRIGHT & DAVIES, INC. | 1857 WILLIAM PENN WAY LANCASTER, PA 17605 | NATIONAL VISION ADMINISTRATORS, LLC | $288 | $0 | $288 | 5.00% |
| ENGLE-HAMBRIGHT & DAVIES, INC.3 Filed as: ENGLE HAMBRIGHT & DAVIES, INC. | 1857 WILLIAM PENN WAY LANCASTER, PA 17605 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $143 | $0 | $143 | 15.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ENGLE HAMBRIGHT & DAVIES, INC BROKER | Insurance agents and brokers Service code 22 | 1857 WILLIAM PENN WAY LANCASTER, PA 17601 | $21K |
| CAPITAL BLUE CROSS EIN 23-0455154 ADMIN | Claims processing Service code 12 | — | $17K |
| THE BENECON GROUP, LLC EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $12K |
| CONNECTCARE3, LLC EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $3K |
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 | 61 | 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) | 61 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 118 | $56K |
| Vision | NATIONAL VISION ADMINISTRATORS, LLC | 112 | $6K |
| Life insurance(2 contracts, 2 carriers) | NATIONWIDE LIFE INSURANCE COMPANY | 61 | $13K |
| Short-term disability(2 contracts, 2 carriers) | NATIONWIDE LIFE INSURANCE COMPANY | 61 | $20K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 54 | $184K |
| Other(3 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 118 | $69K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 118 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.