| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BSI CORPORATE BENEFITS LLC3 | 79 W MARKET ST, STE 400 BETHLEHEM, PA 18018 | AMERITAS LIFE INSURANCE CORP. | $2K | $0 | $2K | 8.00% |
| GABRIEL LISICKY3 | 1605 N. CEDAR CREST BLVD STE 150 ALLENTOWN, PA 18104 | AMFIRST | $1K | $0 | $1K | 7.55% |
| SHAWN HUGHES3 | 79 W MARKET ST STE 400 BETHLEHEM, PA 18018 | AMFIRST | $1K | $3 | $1K | 7.47% |
| MWL3 | PO BOX 14067 JACKSON, MS 392364067 | AMFIRST | $914 | $0 | $914 | 5.00% |
| BSI CORPORATE BENEFITS LLC3 | 79 W MARKET ST, STE 400 BETHLEHEM, PA 18018 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $0 | $1K | 10.52% |
| BSI CORPORATE BENEFITS LLC3 | 79 W MARKET ST, STE 400 BETHLEHEM, PA 18018 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $0 | $2K | 15.00% |
| BENECHOICE ENROLLMENT SOLUTIONS3 | 1574 LITITZ PIKE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $116 | $0 | $116 | 1.67% |
| JAMES BARTLETT LLC3 Filed as: JAMES BARTLETT | 3138 GREENRIDGE DR LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $109 | $0 | $109 | 1.57% |
| ASHLY ELCOCK3 | 200 TATTLETOWN RD AARONSBURG, PA 16820 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $62 | $0 | $62 | 0.89% |
| DAVID PEISCHL3 | 35 E ELIZABETH AVE BETHLEHEM, PA 18018 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | $0 | $15 | 0.22% |
| BSI CORPORATE BENEFITS LLC3 | 79 W MARKET ST, STE 400 BETHLEHEM, PA 18018 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $178 | $0 | $178 | 14.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BSI CORPORATE BENEFITS, LLC BROKER | Insurance agents and brokers Service code 22 | 79 W MARKET ST, SUITE 400 BETHLEHEM, PA 18018 | $21K |
| HIGHMARK EIN 23-1294723 ADMIN | Claims processing Service code 12 | — | $16K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $12K |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $2K |
| HY HOLDINGS INC. ADMIN | Claims processing Service code 12 | 9160 E BAHIA DR STE 201 SCOTTSDALE, AZ 85260 | $2K |
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 | 47 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 49 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AMERITAS LIFE INSURANCE CORP. | 68 | $28K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 68 | $28K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 47 | $10K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 34 | $134K |
| Other(4 contracts, 3 carriers) | AMFIRST | 47 | $41K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 68 | — |
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.