| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HARTMAN EMPLOYEE BENEFITS3 | 420 WILLIAM STREET WILLIAMSPORT, PA 17701 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $32K | — | $32K | 0.52% |
| FIRST NIAGARA RISK MANAGEMENT3 Filed as: FIRST NIAGARA RISK MANAGEMENT INC | 777 CANAL VIEW BLVD STE 100 ROCHESTER, NY 14623 | HARTFORD LIFE AND ACCIDENT | $17K | — | $17K | 5.38% |
| CONVENTRY HEALTH CARE, INC.3 | 750 PRIDES CROSSING, SUITE 200 NEWARK, DE 19713 | DELTA DENTAL OF PENNSYLVANIA | — | $33K | $33K | 11.60% |
| HARTMAN EMPLOYEE BENEFITS3 | 420 WILLIAM STREET WILLIAMSPORT, PA 17701 | HM LIFE INSURANCE COMPANY | $908 | — | $908 | 1.00% |
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 | 671 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 671 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF PENNSYLVANIA | 1,404 | $281K |
| Vision | HM LIFE INSURANCE COMPANY | 1,226 | $91K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 977 | $313K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 977 | $313K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 977 | $313K |
| Prescription drug | CAPITAL ADVANTAGE ASSURANCE COMPANY | 669 | $6.2M |
| Other | HARTFORD LIFE AND ACCIDENT | 977 | $313K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,404 | — |
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.