| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | ONE INTERNATIONAL PLAZA, 4TH FLOOR PHILADELPHIA, PA 19113 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $19K | $0 | $19K | 1.53% |
| HARTMAN EMPLOYEE BENEFITS3 | 420 WILLIAM STREET WILLIAMSPORT, PA 17701 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $6K | $0 | $6K | 0.48% |
| BENECHOICE ENROLLMENT SOLUTIONS3 | UNKNOWN LANCASTER, PA 17601 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7K | $4K | $12K | 9.48% |
| BRENDA H BRIDGES3 Filed as: BRENDA LEE PLACKO | 1863 CREEK ROAD MANHEIM, PA 17545 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8K | $2K | $9K | 7.50% |
| T NASH SKILES INC3 Filed as: T. NASH SKILES, INC. | 1574 LITITZ PIKE LANCASTER, PA 17601 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $3K | $6K | 4.66% |
| CLARICE R MIMS3 Filed as: CLARICE R. MIMS AND OTHER AGENTS | 172-90 HIGHLAND AVENUE JAMAICA ESTATES, NY 11432 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $389 | $4K | 2.97% |
| JAMES BARTLETT LLC3 Filed as: JAMES BARTLETT | 3138 GREENRIDGE DRIVE LANCASTER, PA 17601 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $607 | $3K | 2.36% |
| MARY-JOYCE LICATA3 Filed as: MARY J. YARNELL | 170 EAST HAMILTON LANE BATTLE CREEK, MI 49015 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $149 | $1K | 1.04% |
| THOMAS F HAYES3 Filed as: THOMAS F. HAYES | 2205 OREGON PIKE LANCASTER, PA 17601 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $890 | $119 | $1K | 0.80% |
| USI INSURANCE SERVICES LLC3 | 200 SUMMIT LAKE DRIVE, SUITE 350 VALHALLA, NY 10595 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $4K | $9K | 10.15% |
| USI INSURANCE SERVICES LLC3 | 410 NORTH PRINCE STREET LANCASTER, PA 17603 | AMERICAN UNITED LIFE INSURANCE COMPANY | $1K | $0 | $1K | 20.01% |
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 | 173 | 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) | 173 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CAPITAL ADVANTAGE ASSURANCE COMPANY | 173 | $1.2M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 196 | $87K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 196 | $87K |
| Life insurance | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 3 | $125K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 3 | $125K |
| Long-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 33 | $6K |
| Prescription drug | CAPITAL ADVANTAGE ASSURANCE COMPANY | 173 | $1.2M |
| Other | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 3 | $125K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 196 | — |
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.