| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 4507 N FRONT STREET, SUITE 301 HARRISBURG, PA 17110 | UPMC HEALTH OPTIONS | $35K | — | $35K | 2.94% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 4507 N FRONT STREET, SUITE 301 HARRISBURG, PA 17110 | UPMC HEALTH OPTIONS | $11K | — | $11K | 2.92% |
| DAVID M BURSTIN3 | 6 PPG PLACE, SUITE 1150 PITTSBURGH, PA 15222 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 3.90% |
| ADAM D GOETZ3 | 6 PPG PLACE, SUITE 1150 PITTSBURGH, PA 15222 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $909 | — | $909 | 0.97% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 4507 N FRONT STREET, SUITE 301 HARRISBURG, PA 17110 | UPMC HEALTH BENEFITS | $8K | — | $8K | 9.36% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 4507 N FRONT STREET, SUITE 301 HARRISBURG, PA 17110 | UPMC HEALTH OPTIONS | $315 | — | $315 | 2.99% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 4507 N FRONT STREET, SUITE 301 HARRISBURG, PA 17110 | UPMC HEALTH BENEFITS | $142 | — | $142 | 10.98% |
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 | 120 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts) | UPMC HEALTH OPTIONS | 122 | $1.6M |
| Dental(2 contracts) | UPMC HEALTH BENEFITS | 249 | $92K |
| Vision(2 contracts) | UPMC HEALTH BENEFITS | 249 | $92K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 120 | $93K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 120 | $93K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 120 | $93K |
| Prescription drug(3 contracts) | UPMC HEALTH OPTIONS | 122 | $1.6M |
| Other(3 contracts, 2 carriers) | UPMC HEALTH OPTIONS | 120 | $491K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 249 | — |
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.