| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMERICAN INSURANCE ADMINISTRATORS3 | 4550 LENA DRIVE MECHANICSBURG, PA 17055 | DELTA DENTAL OF PENNSYLVANIA | $2K | — | $2K | 5.00% |
| AMERICAN INSURANCE ADMINISTRATORS3 | 4550 LENA DRIVE MECHANICSBURG, PA 17055 | MONY LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 16.23% |
| AMERICAN INSURANCE ADMINISTRATORS3 | 4550 LENA DR MECHANICSBURG, PA 17055 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $598 | — | $598 | 3.34% |
| PETRINA SKILES3 | 1574 LITITZ PIKE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $479 | — | $479 | 2.67% |
| DAVID J MCCLELLAN3 | 114 ROYAL HORSE WAY REINHOLDS, PA 17569 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $196 | — | $196 | 1.09% |
| EDWARD P DOUGHERTY INC3 | 4550 PRESTWICK DRIVE READING, PA 19606 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $93 | — | $93 | 0.52% |
| LAWRENCE PRICHARD3 | 1204 EATON AVE MIDDLETOWN, OH 45044 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $37 | — | $37 | 0.21% |
| BENECHOICE ENROLLMENT SOLUTIONS3 | 1574 LITITZ PIKE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $37 | — | $37 | 0.21% |
| JAMES BARTLETT LLC3 Filed as: JAMES BARTLETT | 3138 GREENRIDGE DRIVE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.06% |
| AMERICAN INSURANCE ADMINISTRATORS3 | 4550 LENA DR, 3RD FLOOR MECHANICSBURG, PA 17055 | NGL | $481 | — | $481 | 5.00% |
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 | 110 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 110 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF PENNSYLVANIA | 200 | $38K |
| Vision | NGL | 196 | $10K |
| Life insurance(2 contracts, 2 carriers) | MONY LIFE INSURANCE COMPANY OF AMERICA | 137 | $54K |
| Short-term disability | MONY LIFE INSURANCE COMPANY OF AMERICA | 137 | $36K |
| Long-term disability | MONY LIFE INSURANCE COMPANY OF AMERICA | 137 | $36K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 104 | $254K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 200 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.