| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE COALITION3 | 417 WALNUT STREET HARRISBURG, PA 17105 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $35K | $0 | $35K | 14.07% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PENNSYLVANIA, INC. | 125 E ELM ST STE 210 CONSHOHOCKEN, PA 19428 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $16K | $0 | $16K | 6.53% |
| PCI INSURANCE AGENCY3 Filed as: PCI INSURANCE INC | 417 WALNUT STREET HARRISBURG, PA 17101 | UNION SECURITY INSURANCE COMPANY | $7K | $0 | $7K | 6.62% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF PENNSYLVANIA, INC. | 125 E ELM ST STE 210 CONSHOHOCKEN, PA 19428 | UNION SECURITY INSURANCE COMPANY | $5K | $0 | $5K | 4.48% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF PENNSYLVANIA EIN 23-1667011 ADMIN | Claims processing Service code 12 | — | $15K |
| PCI INSURANCE AGENCY BROKER | Insurance agents and brokers Service code 22 | 417 WALNUT STREET HARRISBURG, PA 17101 | $3K |
| BROWN & BROWN OF PA INC BROKER | Insurance agents and brokers Service code 22 | 125 E ELM ST STE 210 CONSHOHOCKEN, PA 19428 | $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 | 197 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 200 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CAPITAL ADVANTAGE ASSURANCE COMPANY | 157 | $245K |
| Vision | VISION BENEFITS OF AMERICA | 145 | $18K |
| Life insurance | UNION SECURITY INSURANCE COMPANY | 197 | $110K |
| Short-term disability | UNION SECURITY INSURANCE COMPANY | 197 | $110K |
| Long-term disability | UNION SECURITY INSURANCE COMPANY | 197 | $110K |
| Prescription drug | CAPITAL ADVANTAGE ASSURANCE COMPANY | 157 | $245K |
| Other | UNION SECURITY INSURANCE COMPANY | 197 | $110K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 197 | — |
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.