| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PENNA. AUTO ASSOC. INS. AGENCY3 Filed as: PENNA AUTO ASSOC. INS. AGENCY | 1925 NORTH FRONT STREET HARRISBURG, PA 17105 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $14K | $0 | $14K | 1.67% |
| PA AUTO ASSOC. INS. AGENCY, INC.3 Filed as: PA AUTO ASSOCIATION INS AGENCY INC | 1925 NORTH FRONT STREET HARRISBURG, PA 17105 | AMERICAN FIDELITY ASSURANCE COMPANY | $5K | $0 | $5K | 5.85% |
| ASSURANCE AGENCY LTD Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | PO BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $4K | $0 | $4K | 4.73% |
| PAA SERVICES INC3 Filed as: PAA SERVICES, INC. | UNKNOWN HARRISBURG, PA 17105 | AMERICAN FIDELITY ASSURANCE COMPANY | $0 | $1K | $1K | 1.54% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | PO BOX 25360 OKLAHOMA, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | -$113 | $0 | -$113 | -0.12% |
| PA AUTO ASSOC. INS. AGENCY, INC.3 Filed as: PA AUTO ASSOCIATION INS AGENCY | 1925 NORTH FRONT STREET HARRISBURG, PA 17102 | SECURITY MUTUAL LIFE INSURANCE COMPANY OF NEW YORK | $406 | $0 | $406 | 11.99% |
| EMERSON REID LLC3 Filed as: EMERSON AND REID | 350 FIFTH AVENUE, SUITE 3700 NEW YORK, NY 10118 | SECURITY MUTUAL LIFE INSURANCE COMPANY OF NEW YORK | $169 | $0 | $169 | 4.99% |
No Schedule C service providers reported on this filing.
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 | 145 | 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) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CAPITAL ADVANTAGE ASSURANCE COMPANY | 150 | $952K |
| Life insurance | SECURITY MUTUAL LIFE INSURANCE COMPANY OF NEW YORK | 145 | $3K |
| Short-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 22 | $94K |
| Long-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 22 | $94K |
| Prescription drug | CAPITAL ADVANTAGE ASSURANCE COMPANY | 150 | $859K |
| Other(2 contracts, 2 carriers) | AMERICAN FIDELITY ASSURANCE COMPANY | 145 | $97K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 150 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.