| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STOUDT, DAVID K3 | 280 GRANITE RUN DR STE 250 LANCASTER, PA 17601 | HIGHMARK, INC. | $2K | $0 | $2K | 7.17% |
| BENJAMIN, KELSEY MICHELLE3 | 413 NORTH CHERRY ST LANCASTER, PA 17602 | HIGHMARK, INC. | $749 | $0 | $749 | 2.17% |
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | 10 N PARK DR STE 200 HUNT VALLEY, MD 21030 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $882 | $3K | 13.84% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $1K | $1K | 6.40% |
| ENGLE-HAMBRIGHT & DAVIES, INC.3 Filed as: ENGLE-HAMBRIGHT & DAVIES INC | PO BOX 11600 LANCASTER, PA 17605 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 5.81% |
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | 10 N PARK DR STE 200 HUNT VALLEY, MD 21030 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $872 | $441 | $1K | 13.84% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $606 | $606 | 6.39% |
| ENGLE-HAMBRIGHT & DAVIES, INC.3 Filed as: ENGLE-HAMBRIGHT & DAVIES INC | PO BOX 11600 LANCASTER, PA 17605 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $550 | $0 | $550 | 5.80% |
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | 10 N PARK DR STE 200 HUNT VALLEY, MD 21030 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $492 | $248 | $740 | 13.82% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $342 | $342 | 6.39% |
| ENGLE-HAMBRIGHT & DAVIES, INC.3 Filed as: ENGLE-HAMBRIGHT & DAVIES INC | PO BOX 11600 LANCASTER, PA 17605 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $312 | $0 | $312 | 5.83% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE BENECON GROUP, LLC EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $59K |
| ASSURED PARTNERS (CENTRAL PA) EIN 30-0837157 BROKER | Insurance agents and brokers Service code 22 | — | $24K |
| REVIVEHEALTH, INC. EIN 86-1279290 ADMIN | Claims processing Service code 12 | — | $9K |
| CAPITAL BLUECROSS EIN 23-0455154 ADMIN | Claims processing Service code 12 | — | -$18K |
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 | 60 | 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) | 60 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | HIGHMARK, INC. | 105 | $35K |
| Vision | HIGHMARK, INC. | 105 | $35K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 69 | $5K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 69 | $19K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 69 | $9K |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 60 | $253K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 69 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 105 | — |
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.