| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GIS BENEFITS INC3 | — | METROPOLITAN LIFE INSURANCE COMPANY | $41 | $0 | $41 | 5.89% |
| ENGLE-HAMBRIGHT & DAVIES, INC.3 Filed as: ENGLE-HAMBRIGHT-DAVIES INC D/B/A EH | — | METROPOLITAN LIFE INSURANCE COMPANY | $33 | $0 | $33 | 4.74% |
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | — | METROPOLITAN LIFE INSURANCE COMPANY | $31 | $0 | $31 | 4.45% |
| ASSUREDPARTNERS3 Filed as: AP BENEFIT ADVISORS LLC DBA CRAWFOR | — | METROPOLITAN LIFE INSURANCE COMPANY | $3 | $0 | $3 | 0.43% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ASSURED PARTNERS (CENTRAL PA) EIN 30-0837157 BROKER | Insurance agents and brokers Service code 22 | — | $4K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $3K |
| CAPITAL BLUECROSS EIN 23-0455154 ADMIN | Claims processing Service code 12 | — | -$3K |
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 | 66 | 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) | 66 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 0 | $0 |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 66 | $27K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 65 | $696 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 66 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.