| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AON CONSULTING INC3 | 29840 NETWORK PL CHICAGO, IL 606731298 | RELIASTAR LIFE INSURANCE COMPANY | $6K | $3K | $10K | 7.81% |
| VIZIENT INSURANCE SERVICES LLC3 | 290 E JOHN CARPENTER FWY IRVING, TX 750622730 | RELIASTAR LIFE INSURANCE COMPANY | $4K | — | $4K | 3.37% |
| VHA MID AMERICA INS SVCS3 Filed as: VHA MID-ATLANTIC INSURANCE SERVICES | 75 REMITTANCE DR. DEPT 1855 CHICAGO, IL 606751855 | RELIASTAR LIFE INSURANCE COMPANY | $2K | — | $2K | 1.41% |
| A J KUZNESKI JR INC3 Filed as: A J KUZNESKI, JR. INC. | 19 NORTH 6TH STREET INDIANA, PA 15701 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $865 | $6K | 5.40% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED CONCORDIA COMPANIES, INC EIN 25-1687586 NONE | Contract Administrator Service code 13 | — | $51K |
| HIGHMARK EIN 23-1294723 NONE | Contract Administrator Service code 13 | — | $45K |
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 | 1,174 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 32 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,206 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision(2 contracts) | VISION BENEFITS OF AMERICA | 787 | $200K |
| Life insurance(2 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 1,064 | $239K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 886 | $115K |
| Other | RELIASTAR LIFE INSURANCE COMPANY | 1,064 | $123K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,064 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.