| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SPECIAL RISK INSURANCE SERVICES INC3 | 508 COOPER ROAD P.O. BOX 1108 VOORHEES, NJ 08043 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $53K | — | $53K | 5.86% |
| FRANCIS W. WARD, JR.3 | 533 MILLBROOK ROAD P.O. BOX 410 DEVON, PA 193330410 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $38K | — | $38K | 4.14% |
| SPECIAL RISK INSURANCE SERVICES INC3 | P.O. BOX 1108 VOORHEES, NJ 080437108 | STANDARD INSURANCE COMPANY | $6K | — | $6K | 4.81% |
| FRANCIS W. WARD, JR.3 | P.O. BOX 410 DEVON, PA 193330410 | STANDARD INSURANCE COMPANY | $4K | — | $4K | 3.35% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HIGHMARK EIN 23-1294723 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $719K |
| UNITED CONCORDIA COMPANIES, INC. EIN 25-1687586 NONE | Claims processing Service code 12 | — | $31K |
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 | 1,276 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 172 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,448 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY | 217 | $82K |
| Vision | VISION SERVICE PLAN | 621 | $102K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,189 | $909K |
| Short-term disability | INSURANCE ADMINISTRATOR OF AMERICA, INC. | 734 | $18K |
| Long-term disability | STANDARD INSURANCE COMPANY | 587 | $131K |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,189 | $928K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,189 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.