| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALPHA BENEFITS GROUP INC3 Filed as: ALPHA BENEFITS GROUP INC. | 949 EASTON ROAD, SUITE 200 WARRINGTON, PA 18976 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $3K | $5K | 12.21% |
| INDEPENDENCE PLANNING GROUP3 Filed as: INDEPENDENCE PLANNING GROUP, LLC | 1767 SENTRY PARKWAY WEST BLUE BELL, PA 19422 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $25 | $0 | $25 | 0.06% |
| COMPREHENSIVE BENEFIT MARKETING SVC3 Filed as: COMPREHENSIVE BENEFIT MKTG SVCS | 5995 LEMON STREET EAST PETERSBURG, PA 17520 | USABLE LIFE | $1K | $0 | $1K | 12.60% |
| CONSOLIDATED BENEFITS INC3 Filed as: CONSOLIDATED BENEFITS INC. | PO BOX 774232 HARRISBURG, PA 17177 | USABLE LIFE | $561 | $0 | $561 | 5.40% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PENNSYLVANIA, LP. | 125 E ELM STREET, SUITE 210 CONSHOHOCKEN, PA 19428 | NATIONAL VISION ADMINISTRATORS, LLC | $374 | $0 | $374 | 4.99% |
| COMPREHENSIVE BENEFIT MARKETING SVC3 Filed as: COMPREHENSIVE BENEFIT MKTG SVCS INC | 5995 LEMON STREET EAST PETERSBURG, PA 17520 | USABLE LIFE | $402 | $0 | $402 | 12.60% |
| CONSOLIDATED BENEFITS INC3 Filed as: CONSOLIDATED BENEFITS INC. | PO BOX 774232 HARRISBURG, PA 17177 | USABLE LIFE | $172 | $0 | $172 | 5.39% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COVENTRY/HEALTH AMERICA EIN 62-1411933 ADMIN | Claims processing Service code 12 | — | $57K |
| BROWN & BROWN INSURANCE BROKER | Insurance agents and brokers Service code 22 | 125 E ELM ST. SUITE 210 CONSHOHOCKEN, PA 19428 | $41K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $18K |
| CONNECTCARE3 EIN 23-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $6K |
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 | 127 | 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) | 127 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 81 | $41K |
| Vision | NATIONAL VISION ADMINISTRATORS, LLC | 133 | $7K |
| Life insurance | USABLE LIFE | 127 | $3K |
| Short-term disability | USABLE LIFE | 127 | $10K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 117 | $240K |
| Other | USABLE LIFE | 127 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 133 | — |
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.