| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COMPREHENSIVE BENEFIT MARKETING SVC3 | 5995 LEMON STREET EAST PETERSBURG, PA 17520 | DELTA DENTAL OF PENNSYLVANIA | $2K | — | $2K | 1.52% |
| COMPREHENSIVE BENEFIT MARKETING SVC3 | 5995 LEMON STREET EAST PETERSBURG, PA 17520 | SUN LIFE ASSURANCE COMPANY OF CANADA | $7K | — | $7K | 7.59% |
| STEPHEN M HENSS LLC3 | 44 HERSHEY LANE PARKESBURG, PA 19365 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $753 | $4K | 10.57% |
| TANYA WISHARD3 | PO BOX 307 CODORUS, PA 17311 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $505 | $3K | 6.50% |
| JAMES CAREY3 | 1109 SAUNDERS COURT WEST CHESTER, PA 19380 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 5.07% |
| CORPORATE HEALTHCARE STRATEGIES LLC3 | 250 GRANITE RUN DRIVE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $240 | — | $240 | 0.57% |
| CATHY GOOD3 | 2799 FLOWING SPRINGS ROAD SPRING CITY, PA 19475 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $173 | — | $173 | 0.41% |
| ARDENA L MCVICKER3 | 73 KATYDID LANE MORGANTOWN, PA 19543 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $131 | — | $131 | 0.31% |
| BRENT L GOODE3 Filed as: BRENT MCVICKER | 73 KATYDID LANE MORGANTOWN, PA 19543 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $117 | — | $117 | 0.28% |
| RONALD OLIANO3 | 9 LONDON COURT NEWTOWN, PA 18940 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $56 | — | $56 | 0.13% |
| WILLIAM E GOOD3 | 2799 FLOWING SPRINGS ROAD SPRING CITY, PA 19475 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| VERIS BENEFITS CONSORTIUM NONE | Claims processing; Other services; Insurance agents and brokers; Direct payment from the plan Service code 12 | P.O. BOX 5406 LANCASTER, PA 176065406 | $110K |
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 | 173 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 44 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 223 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF PENNSYLVANIA | 243 | $102K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 169 | $95K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 169 | $95K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 169 | $95K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 124 | $328K |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 169 | $137K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 243 | — |
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.