| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEE ATTACHED3 Filed as: SEE ATTACHED LIST OF AGENTS | — | DELTA DENTAL OF PENNSYLVANIA | $270K | — | $270K | 8.92% |
| MANUFACTURER & BUSINESS ASSOCIATION3 Filed as: MANUFACTURER & BUSINESS ASSOC INS | 2171 WEST 38TH STREET ERIE, PA 16508 | UNITED CONCORDIA INSURANCE COMPANY | $44K | — | $44K | 7.39% |
| SEE ATTACHED3 Filed as: SEE ATTACHED LIST OF AGENTS | — | HARTFORD LIFE AND ACCIDENT | $37K | $2K | $39K | 12.63% |
| MANUFACTURER & BUSINESS ASSOCIATION3 Filed as: MANUFACTURER & BUSINESS ASSOC INS | 2171 WEST 38TH STREET ERIE, PA 16508 | UNITED CONCORDIA DENTAL PLANS OF PENNSYLVANIA, INC. | $1K | — | $1K | 7.47% |
| MANUFACTURER & BUSINESS ASSOCIATION3 Filed as: MANUFACTURER & BUSINESS ASSOC INS | 2171 WEST 38TH STREET ERIE, PA 16508 | UNITED CONCORDIA INSURANCE COMPANY | $189 | — | $189 | 4.66% |
| LOESEL-SCHAAF INSURANCE AGENCY INC3 | 3537 W 12TH ST ERIE, PA 16505 | UNITED CONCORDIA INSURANCE COMPANY | $116 | — | $116 | 2.86% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| C.W. BREITSMAN ASSOCIATES, LLC N/A | Contract Administrator Service code 13 | 401 LIBERTY AVENUE PITTSBURGH, PA 15222 | $91K |
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 | 7,438 | 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) | 7,438 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(4 contracts, 3 carriers) | DELTA DENTAL OF PENNSYLVANIA | 5,955 | $3.6M |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 700 | $35K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 1,477 | $310K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 1,477 | $310K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 1,477 | $310K |
| Other | HARTFORD LIFE AND ACCIDENT | 1,477 | $310K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,955 | — |
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.