| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMPLOYEE BENEFIT CONSULTANTS3 | 682 N BROOKSIDE ROAD STE 100 ALLENTOWN, PA 181069646 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 8.52% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 1787 SENTRY PKWY W STE 320 BLUE BELL, PA 194222240 | PRINCIPAL LIFE INSURANCE COMPANY | $679 | $166 | $845 | 5.19% |
| KORE INSURANCE HOLDINGS LLC3 Filed as: KORE INSURANCE HOLDINGS, LLC | 354 EISENHOWER PKWY #1 LIVINGSTON, NJ 070391022 | PRINCIPAL LIFE INSURANCE COMPANY | $3 | $0 | $3 | 0.02% |
| SAVOY ASSOCIATES3 Filed as: DONALD SAVOY INC | 25B HANOVER ROAD STE 220 FLORHAM PARK, NJ 079321443 | PRINCIPAL LIFE INSURANCE COMPANY | $1 | $0 | $1 | 0.01% |
| EMPLOYEE BENEFIT CONSULTANTS3 Filed as: EMPLOYEE BENEFITS CONSULTANTS, LLC | 682 NORTH BROOKSIDE ROAD SUITE 100 ALLENTOWN, PA 18106 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $719 | $0 | $719 | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPLOYEE BENEFITS CONSULTANTS, LLC EIN 20-2277261 BROKER | Insurance agents and brokers Service code 22 | — | $11K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $9K |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $2K |
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 | 28 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 29 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 51 | $16K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 51 | $16K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 4 | $7K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 28 | $90K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 51 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.