| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALPHA BENEFITS GROUP INC3 | 125 E ELM ST STE 210 CONSHOHOCKEN, PA 19428 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 6.54% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES IN | 300 N BEACH ST DAYTONA BEACH, FL 32114 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $0 | $2K | $2K | 5.08% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PENNSYLVANIA | 125 E ELM ST STE 210 CONSHOHOCKEN, PA 19428 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $0 | $2K | 15.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | 1 BEACON ST STE 17100 BOSTON, MA 02108 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $772 | $0 | $772 | 4.89% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PENNSYLVANIA LP | 125 E ELM ST STE 210 CONSHOHOCKEN, PA 19428 | NATIONAL VISION ADMINISTRATORS, LLC | $268 | $0 | $268 | 4.24% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES, I | 300 N BEACH ST DAYTONA BEACH, FL 32114 | NATIONAL VISION ADMINISTRATORS, LLC | $49 | $0 | $49 | 0.77% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PENNSYLVANIA | 125 E ELM ST STE 210 CONSHOHOCKEN, PA 19428 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $533 | $0 | $533 | 11.00% |
| PACIFIC RESOURCE BENEFITS ADVISORS3 | 1 BEACON ST STE 17100 BOSTON, MA 02108 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $238 | $0 | $238 | 4.91% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PENNSYLVANIA | 125 E ELM ST STE 210 CONSHOHOCKEN, PA 19428 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $685 | $0 | $685 | 15.01% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | 1 BEACON ST STE 17100 BOSTON, MA 02108 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $228 | $0 | $228 | 4.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BROWN & BROWN (PA) EIN 20-0878127 BROKER | Insurance agents and brokers Service code 22 | — | $30K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $15K |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $4K |
| CAPITAL BLUECROSS EIN 23-0455154 ADMIN | Claims processing Service code 12 | — | -$7K |
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 | 58 | 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) | 58 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 58 | $37K |
| Vision | NATIONAL VISION ADMINISTRATORS, LLC | 151 | $6K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 75 | $5K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 76 | $16K |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 54 | $319K |
| Other(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 75 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 151 | — |
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."
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.