| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PENNSYLVANIA | 125 E ELM ST STE 210 CONSHOHOCKEN, PA 19428 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $3K | $0 | $3K | 9.29% |
| THE FOLEY INSURANCE AGENCY, INC.3 Filed as: FOLEY INS AGENCY INC | 8 SPRING HOUSE SUITE 202 LOWER GWYNEDD, PA 19002 | HARTFORD LIFE AND ACCIDENT | $2K | $0 | $2K | 9.72% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PA | 125 E ELM ST STE 210 CONSHOHOCKEN, PA 19428 | HARTFORD LIFE AND ACCIDENT | $1K | $0 | $1K | 4.84% |
| STRATEGIC NON-MEDICAL SOLUTION3 Filed as: STRATEGIC NON-MEDICAL SOLUTIONS, LL | ONE BEACON STREET SUITE 1700 BOSTON, MA 02108 | HARTFORD LIFE AND ACCIDENT | $0 | $518 | $518 | 2.39% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 100 RIALTO PLACE STE 900 MELBOURNE, FL 32901 | HARTFORD LIFE AND ACCIDENT | $0 | $220 | $220 | 1.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAPITAL BLUECROSS EIN 23-0455154 ADMIN | Claims processing Service code 12 | — | $30K |
| BROWN & BROWN (PA) EIN 20-0878127 BROKER | Insurance agents and brokers Service code 22 | — | $16K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $13K |
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 | 61 | 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) | 61 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CAPITAL ADVANTAGE ASSURANCE COMPANY | 57 | $28K |
| Vision | CAPITAL ADVANTAGE ASSURANCE COMPANY | 57 | $28K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 129 | $22K |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 26 | $164K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 129 | — |
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.