| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DH EVANS TPA, LLC5 Filed as: D H EVANS TPA LLC | 4785 LINGLESTOWN ROAD STE 200 HARRISBURG, PA 17112 | FORT DEARBORN LIFE INSURANCE COMPANY | $2K | — | $2K | 1.67% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CHARLES W JOHNSTON PC EIN 23-2077724 NONE | Legal; Direct payment from the plan Service code 29 | 101 ERFORD ROAD CAMP HILL, PA 17001 | $20K |
| ALAN ROSS AND COMPANY, PC EIN 20-5367494 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | 10 HEARTHSTONE CT, STE 100 READING, PA 19606 | $11K |
| CAP TRUST FINANCIAL ADVISORS EIN 26-0058143 NONE | Investment management fees paid directly by plan Service code 51 | 4208 SIX FORKS ROAD, STE 1700 RALEIGH, NC 27609 | $8K |
| BEYER BARBER EIN 23-2503024 NONE | Actuarial; Direct payment from the plan Service code 11 | 1136 HAMILTON STREET, STE 103 ALLENTOWN, PA 18101 | $5K |
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 | 354 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 126 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 480 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CAPITAL ADVANTAGE ASSURANCE COMPANY | 499 | $261K |
| Dental | UNITED CONCORDIA COMPANIES INC | 499 | $24K |
| Vision | HM LIFE INSURANCE COMPANY | 1,088 | $55K |
| Life insurance | FORT DEARBORN LIFE INSURANCE COMPANY | 365 | $106K |
| Short-term disability | FORT DEARBORN LIFE INSURANCE COMPANY | 365 | $106K |
| Prescription drug | CAPITAL ADVANTAGE ASSURANCE COMPANY | 499 | $261K |
| Stop-loss / reinsurancereinsurance | AVALON INSURANCE COMPANY | 499 | $375K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,088 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.