| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE DJB GROUP3 Filed as: THE DJB GROUP INC. | 262 CHESTNUT STREET, SUITE 200 MEADVILLE, PA 16335 | HIGHMARK INC. | $34K | $0 | $34K | 4.24% |
| THE DJB GROUP3 Filed as: THE DJB GROUP INC. | 262 CHESTNUT STREET, SUITE 200 MEADVILLE, PA 16335 | DELTA DENTAL OF PENNSYLVANIA | $3K | $0 | $3K | 9.40% |
| THE DJB GROUP3 Filed as: THE DJB GROUP INC. | 262 CHESTNUT STREET, SUITE 200 MEADVILLE, PA 16335 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | $0 | $2K | 14.49% |
| THE DJB GROUP3 Filed as: THE DJB GROUP INC. | 262 CHESTNUT STREET, SUITE 200 MEADVILLE, PA 16335 | VISION BENEFITS OF AMERICA | $457 | $0 | $457 | 7.01% |
| MFR. AND BUS. ASSOC. INS. AGENCY3 | 2171 WEST 38TH STREET ERIE, PA 16508 | VISION BENEFITS OF AMERICA | $129 | $0 | $129 | 1.98% |
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 | 132 | 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) | 132 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK INC. | 133 | $799K |
| Dental | DELTA DENTAL OF PENNSYLVANIA | 102 | $34K |
| Vision | VISION BENEFITS OF AMERICA | 88 | $7K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 102 | $17K |
| Prescription drug | HIGHMARK INC. | 133 | $799K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 133 | — |
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.