| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JRG ADVISORS LLC3 | 7000 STONEWOOD DRIVE, SUITE 251 WEXFORD, PA 15090 | UPMC HEALTH OPTIONS | $22K | — | $22K | 1.06% |
| ASSUREDPARTNERS3 Filed as: THE HDH GROUP, INC. | 210 SIXTH AVENUE 30TH FLOOR PITTSBURGH, PA 15222 | UPMC HEALTH OPTIONS | $11K | — | $11K | 0.50% |
| ASSUREDPARTNERS3 Filed as: THE HDH GROUP, INC. | 210 SIXTH AVENUE 30TH FLOOR PITTSBURGH, PA 15222 | DELTA DENTAL OF PENNSYLVANIA | $985 | — | $985 | 0.92% |
| JRG ADVISORS LLC3 | 7000 STONEWOOD DRIVE, SUITE 251 WEXFORD, PA 15090 | DELTA DENTAL OF PENNSYLVANIA | $242 | — | $242 | 0.23% |
| ASSUREDPARTNERS3 Filed as: THE HDH GROUP, INC., | 210 SIXTH AVENUE 30TH FLOOR PITTSBURGH, PA 15222 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 9.72% |
| JRG ADVISORS LLC3 | 7000 STONEWOOD DRIVE SUITE 251 WEXFORD, PA 15090 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $446 | $2K | 7.16% |
| ASSUREDPARTNERS3 Filed as: THE HDH GROUP, INC., | 210 SIXTH AVENUE 30TH FLOOR PITTSBURGH, PA 15222 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 7.13% |
| JRG ADVISORS LLC3 | 7000 STONEWOOD DRIVE SUITE 251 WEXFORD, PA 15090 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $598 | $305 | $903 | 5.84% |
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 | 365 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 368 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UPMC HEALTH OPTIONS | 455 | $2.1M |
| Dental | DELTA DENTAL OF PENNSYLVANIA | 450 | $107K |
| Vision | EYEMED | 282 | $21K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 365 | $15K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 365 | $23K |
| Prescription drug | UPMC HEALTH OPTIONS | 455 | $2.1M |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 365 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 455 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.