| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THOMAS VERGHESE3 | 30 KEYSTONE COURT LEOLA, PA 17540 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 12.14% |
| SUSQUEHANNA INSURANCE MGT LTD3 | 650 DELP ROAD LANCASTER, PA 17601 | GUARDIAN LIFE INSURANCE COMPANY | $1K | $0 | $1K | 15.66% |
| INDEPENDENCE PLANNING GROUP3 Filed as: INDEPENDENCE PLANNING GROUP, L | 1767 SENTRY PKWY WEST SUITE 311 BLUE BELL, PA 19422 | GUARDIAN LIFE INSURANCE COMPANY | $13 | $0 | $13 | 0.16% |
| MURRAY INS ASSOC INC3 Filed as: MURRAY INSURANCE ASSOCIATES IN | 39 N DUKE ST PO BOX 1728 LANCASTER, PA 17608 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $812 | $0 | $812 | 15.86% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HIGHMARK EIN 23-1294723 ADMIN | Claims processing Service code 12 | — | $65K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $21K |
| SUSQUEHANNA INSURANCE MGNT LTD BROKER | Insurance agents and brokers Service code 22 | 650 DELP ROAD LANCATER, PA 176013035 | $18K |
| CONNECTCARE 3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $6K |
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 | 118 | 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) | 118 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN LIFE INSURANCE COMPANY | 102 | $8K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 118 | $5K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 12 | $12K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 12 | $12K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 100 | $306K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 118 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 118 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.