| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ENGLE-HAMBRIGHT & DAVIES, INC.3 Filed as: ENGLE HAMBRIGHT & DAVIES, INC. | 1857 WILLIAM PENN WAY PO BOX 11600 LANCASTER, PA 17605 | SUN LIFE ASSURANCE COMPANY OF CANADA | $7K | $0 | $7K | 12.42% |
| JAMES R NELLIGAN & ASSOCIATES LLC3 | 1933 STATE ROUTE 35 SUITE 368 WALL, NJ 07719 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | $0 | $3K | 5.03% |
| ENGLE-HAMBRIGHT & DAVIES, INC.3 Filed as: ENGLE HAMBRIGHT & DAVIES, INC. | 1857 WILLIAM PENN WAY LANCASTER, PA 17605 | NATIONAL VISION ADMINISTRATORS, LLC | $286 | $0 | $286 | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ENGLE HAMBRIGHT & DAVIES, INC EIN 23-0558310 BROKER | Insurance agents and brokers Service code 22 | — | $22K |
| THE BENECON GROUP, LLC EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $13K |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $4K |
| CAPITAL BLUE CROSS EIN 23-0455154 ADMIN | Claims processing Service code 12 | — | $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 | 55 | 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) | 55 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 56 | $56K |
| Vision | NATIONAL VISION ADMINISTRATORS, LLC | 121 | $6K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 0 | $0 |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 0 | $0 |
| Stop-loss / reinsurancereinsurance | OPTUM HEALTH (UNIMERICA INSURANCE COMPANY) | 52 | $274K |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 56 | $56K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 121 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.