| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BSI CORPORATE BENEFITS LLC3 | 28411 NORTHWESTERN HWY SUITE 1150 SOUTHFIELD, MI 48034 | THE GUARDIAN LIFE INSURANCE COMPANY | $12K | $0 | $12K | 11.30% |
| MAZZMAR LLC3 | 1767 SENTRY PKWY W STE 200 BLUE BELL, PA 19422 | THE GUARDIAN LIFE INSURANCE COMPANY | $38 | $0 | $38 | 0.03% |
| INDEPENDENCE PLANNING GROUP3 Filed as: INDEPENDENCE PLANNING GROUP, LLC | 2173 EMBASSY DRIVE LANCASTER, PA 17603 | THE GUARDIAN LIFE INSURANCE COMPANY | $24 | $0 | $24 | 0.02% |
| BENEFITSYNERGY LLC3 | 3935 WHITE BARN LANE EASTON, PA 18045 | THE GUARDIAN LIFE INSURANCE COMPANY | -$139 | $0 | -$139 | -0.13% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BSI CORPORATE BENEFITS BROKER | Insurance agents and brokers Service code 22 | 79 WEST MARKET STREET SUITE 400 BETHLEHEM, PA 18018 | $50K |
| THE BENECON GROUP, LLC EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $17K |
| HY HOLDINGS INC. EIN 30-0947669 ADMIN | Claims processing Service code 12 | — | $8K |
| CAPITAL BLUE CROSS EIN 23-0455154 ADMIN | Claims processing Service code 12 | — | $5K |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $5K |
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 | 74 | 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) | 74 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY | 76 | $110K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY | 76 | $110K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY | 76 | $110K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY | 76 | $110K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY | 76 | $110K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 74 | $274K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY | 76 | $110K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 76 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.