| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: HDH GROUP INC | 1250 TOWER LANE ERIE, PA 16505 | AFLAC | $1K | — | $1K | 5.69% |
| MARILYN WYMAN3 | 203 AIKEN ROAD NEW CASTLE, PA 16101 | AFLAC | $778 | $28 | $806 | 3.39% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS | — | AFLAC | $693 | $17 | $710 | 2.98% |
| STEPHANIE V BOOMGAARDEN3 Filed as: STEPHANIE BOOMGAARDEN | 207 LAKELAND DRIVE EDINBORO, PA 16412 | AFLAC | $434 | $42 | $476 | 2.00% |
| SMITH BENEFITS CONSULTING GROUP3 | 810 RIVER AVENUE, SUITE 230 PITTSBURGH, PA 15212 | AFLAC | $113 | $16 | $129 | 0.54% |
| MICHELLE H KELLEY3 | 2411 W 26TH STREET ERIE, PA 16506 | AFLAC | $127 | — | $127 | 0.53% |
| RONALD PUSZ3 | 18282 TECHNOLOGY DRIVE, SUITE 205 MEADVILLE, PA 16335 | AFLAC | $123 | — | $123 | 0.52% |
| ASSUREDPARTNERS3 Filed as: HDH GROUP, INC. | 210 6TH AVENUE, 30TH FLOOR PITTSBURGH, PA 15222 | HARTFORD LIFE AND ACCIDENT | $2K | — | $2K | 10.28% |
| FNA INSURANCE SERVICES INC3 Filed as: FNA INSURANCE SERVICES, INC. | 1000 WOODBURY ROAD, SUITE 403 WOODBURY, NY 11797 | HARTFORD LIFE AND ACCIDENT | — | $1K | $1K | 5.79% |
| ASSUREDPARTNERS3 Filed as: HDH GROUP INC | 210 6TH AVENUE 30TH FLOOR PITTSBURGH, PA 15222 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 14.25% |
| FNA INSURANCE SERVICES INC3 Filed as: FNA INSURANCE SERVICES, INC. | 1000 WOODBURY ROAD, SUITE 403 WOODBURY, NY 11797 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $701 | $701 | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HIGHMARK INC. EIN 23-1294723 TPA + NETWORK | Claims processing; Other services Service code 12 | — | $99K |
| THE HDH GROUP DBA HUB INTERNATIONAL EIN 25-1428002 TPA + INSURANCE BROKER | Claims processing; Insurance agents and brokers Service code 12 | — | $9K |
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 | 164 | 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) | 164 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 195 | $36K |
| Long-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 195 | $36K |
| Other(3 contracts, 3 carriers) | AFLAC | 195 | $60K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 195 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.