| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HARTMAN EMPLOYEE BENEFITS3 Filed as: HARTMAN EMPLOYEE BENEFITS, INC. | 420 WILLIAM STREET PO BOX 1087 WILLIAMSPORT, PA 177031087 | HIGHMARK | $218K | $0 | $218K | 4.01% |
| BSI CORPORATE BENEFITS LLC3 | 79 WEST MARKET STREET SUITE 400 BETHLEHEM, PA 18018 | DELTA DENTAL OF PENNSYLVANIA | $11K | $0 | $11K | 5.00% |
| BSI CORPORATE BENEFITS LLC3 Filed as: BSI CORPORATE BENEFITS, LLC | 79 W MARKET STREET SUITE 400 BETHLEHEM, PA 18018 | LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 5.00% |
| BSI CORPORATE BENEFITS LLC3 Filed as: BSI CORPORATE BENEFITS, LLC | 79 W MARKET STREET SUITE 400 BETHLEHEM, PA 18018 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | $0 | $10K | 15.00% |
| BSI CORPORATE BENEFITS LLC3 | 79 W MARKET STREET SUITE 400 BETHLEHEM, PA 18018 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $0 | $1K | 5.00% |
| BSI CORPORATE BENEFITS LLC3 | 79 WEST MARKET STREET SUITE 400 BETHLEHEM, PA 18018 | UNION SECURITY INSURANCE COMPANY | $3K | $0 | $3K | 13.24% |
| BSI CORPORATE BENEFITS LLC3 | 79 WEST MARKET STREET SUITE 400 BETHLEHEM, PA 18018 | UNION SECURITY INSURANCE COMPANY | $236 | $0 | $236 | 2.99% |
| BSI CORPORATE BENEFITS LLC3 Filed as: BSI CORPORATE BENEFITS, LLC | 79 W MARKET STREET SUITE 400 BETHLEHEM, PA 18018 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $281 | $0 | $281 | 5.01% |
| BSI CORPORATE BENEFITS LLC3 Filed as: BSI CORPORATE BENEFITS, LLC | 79 W MARKET STREET SUITE 400 BETHLEHEM, PA 18018 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $381 | $0 | $381 | 9.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TASC ADMIN | Claims processing Service code 12 | 2302 INTERNATIONAL LANE MADISON, WI 537043140 | $16K |
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 | 826 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 828 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK | 1,044 | $5.4M |
| Dental | DELTA DENTAL OF PENNSYLVANIA | 1,061 | $228K |
| Vision | HIGHMARK | 1,044 | $5.4M |
| Life insurance(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 713 | $62K |
| Short-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF AMERICA | 826 | $120K |
| Long-term disability(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 808 | $94K |
| Prescription drug | HIGHMARK | 1,044 | $5.4M |
| Other(3 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 713 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,061 | — |
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.