| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CCAB INSURANCE & BENEFITS, INC.3 Filed as: CCAB INSURANCE & BENEFITS INC. | 2101 OREGON PIKE SUITE 202 LANCASTER, PA 17601 | METROPOLITAN LIFE INSURANCE COMPANY | $233 | $0 | $233 | 1.28% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $93 | $0 | $93 | 0.51% |
| PETRINA SKILES3 | 1574 LITITZ PIKE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | $1 | $8 | 0.33% |
| CCAB INSURANCE & BENEFITS, INC.3 | 2101 OREGON PIKE SUITE 202 LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.21% |
| BENECHOICE ENROLLMENT SOLUTIONS3 | 1574 LITITZ PIKE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.04% |
| CCAB INSURANCE & BENEFITS, INC.3 | 2101 OREGON PIKE SUITE 202 LANCASTER, PA 17601 | NATIONAL VISION ADMINISTRATORS, LLC | $50 | $0 | $50 | 10.06% |
| CCAB INSURANCE & BENEFITS, INC.3 | 2101 OREGON PIKE SUITE 202 LANCASTER, PA 17601 | STARMOUNT LIFE INSURANCE COMPANY | $14 | $0 | $14 | 9.72% |
| TIMOTHY SKILES3 | 1574 LITITZ PIKE LANCASTER, PA 17601 | STARMOUNT LIFE INSURANCE COMPANY | $0 | $7 | $7 | 4.86% |
| CCAB INSURANCE & BENEFITS, INC.3 Filed as: CCAB INSURANCE & BENEFITS INC | 2101 OREGON PIKE SUITE 202 LANCASTER, PA 17601 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3 | $0 | $3 | 12.00% |
| TIMOTHY SKILES3 | 1574 LITITZ PIKE LANCASTER, PA 17601 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $1 | $1 | 4.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CCAB INSURANCE & BENEFITS, INC. BROKER | Insurance agents and brokers Service code 22 | 2101 OREGON PIKE, SUITE 202 LANCASTER, PA 17601 | $2K |
| THE BENECON GROUP, LLC EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $2K |
| CONNECTCARE 3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $524 |
| CAPITAL BLUECROSS EIN 23-0455154 ADMIN | Claims processing Service code 12 | — | -$2K |
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 | 121 | 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) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 0 | $144 |
| Vision | NATIONAL VISION ADMINISTRATORS, LLC | 94 | $497 |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 121 | $18K |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 95 | $28K |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 121 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 121 | — |
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."
No prospect flags tripped on this filing.