| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROCHE FINANCIAL INC3 | 1610 E. THIRD STREET WILLIAMSPORT, PA 17701 | HUMANA BENEFIT PLAN OF ILLINOIS, INC. | $900 | — | $900 | 0.33% |
| ROCHE FINANCIAL INC3 | 1610 E. THIRD STREET WILLIAMSPORT, PA 17701 | HUMANA BENEFIT PLAN OF ILLINOIS, INC. | $150 | — | $150 | 0.09% |
| BENEFIT MANAGEMENT, INC.3 Filed as: BENEFIT MANAGEMENT GROUP INC | 10 N DORCAS STREET LEWISTOWN, PA 17044 | UNION SECURITY INSURANCE COMPANY | $7K | — | $7K | 10.00% |
| EMERSON REID LLC3 Filed as: EMERSON REID & CO. | 1305 WALT WHITMAN RD STE 310 MELVILLE, NY 11747 | UNION SECURITY INSURANCE COMPANY | — | $2K | $2K | 3.00% |
| ROCHE FINANCIAL INC3 Filed as: ROCHE FINANCIAL INC. | 1610 E. THIRD STREET WILLIAMSPORT, PA 17701 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 13.09% |
| EMERSON REID LLC3 | 630 W GERMANTOWN PIKE, STE 215 PLYMOUTH MEETING, PA 19462 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 5.46% |
| PENTRA LLC3 Filed as: PENTRA INC | 795 E LANCASTER AVE STE 210 VILLANOVA CENTER, PA 19085 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 10.06% |
| BENEFIT ADVISORS NETWORK LLC3 | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $154 | $154 | 1.17% |
| BENEFIT MANAGEMENT, INC.3 Filed as: BENEFIT MANAGEMENT GROUP INC | 10 N DORCAS STREET LEWISTOWN, PA 17044 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| EMERSON REID LLC3 Filed as: EMERSON REID & CO. | 4507 N. FRONT STREET, SUITE 301 HARRISBURG, PA 17110 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $332 | — | $332 | 3.00% |
| ROCHE FINANCIAL INC3 Filed as: ROCHE FINANCIAL INC. | 1610 E. THIRD STREET WILLIAMSPORT, PA 17701 | HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC | $50 | — | $50 | 2.11% |
| ROCHE FINANCIAL INC3 Filed as: ROCHE FINANCIAL INC. | 1610 E. THIRD STREET WILLIAMSPORT, PA 17701 | HUMANA INSURANCE COMPANY | $100 | — | $100 | 4.22% |
| ROCHE FINANCIAL INC3 | 1610 E. THIRD STREET WILLIAMSPORT, PA 17701 | HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC | $50 | — | $50 | 2.11% |
| ROCHE FINANCIAL INC3 | 1610 E. THIRD STREET WILLIAMSPORT, PA 17701 | HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC | $50 | — | $50 | 2.30% |
| HARTMAN EMPLOYEE BENEFITS3 Filed as: HARTMAN EMPLOYEE BENEFITS, INC. | 420 WILLIAM ST., P.O. BOX 1087 WILLIAMSPORT, PA 17701 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $195 | — | $195 | 15.00% |
| ROCHE FINANCIAL INC3 Filed as: ROCHE FINANCIAL INC. | 1610 E. THIRD STREET WILLIAMSPORT, PA 17701 | HUMANA INSURANCE COMPANY | $4K | — | $4K | 202500.00% |
| ROCHE FINANCIAL INC3 | 1610 E. THIRD STREET WILLIAMSPORT, PA 17701 | HUMANA INSURANCE COMPANY | $6K | $129 | $6K | — |
No Schedule C service providers reported on this filing.
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 | 170 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 150 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 320 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNION SECURITY INSURANCE COMPANY | 123 | $66K |
| Vision | DAVIS VISION (HIGHMARK OF NY) | 233 | $19K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 216 | $42K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 216 | $28K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 48 | $11K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS OF NORTHEASTERN PA | 264 | $246K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 0 | $1K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 264 | — |
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.