| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEUBERT & ASSOCIATES, INC.3 | 1010 OHIO RIVER BLVD. PITTSBURGH, PA 15202 | AETNA LIFE INSURANCE COMPANY | $3K | — | $3K | 5.39% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES | 1712 MOUNT NEBO RD SEWICKLEY, PA 151438526 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES | 1712 MT. NEBO ROAD SEWICKLEY, PA 15143 | VISION BENEFITS OF AMERICA | $400 | — | $400 | 4.99% |
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 | 121 | 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) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AETNA LIFE INSURANCE COMPANY | 202 | $52K |
| Vision | VISION BENEFITS OF AMERICA | 73 | $8K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 121 | $25K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 121 | $16K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 121 | $9K |
| Stop-loss / reinsurancereinsurance | HIGHMARK CASUALTY INSURANCE COMPANY | 86 | $144K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 121 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 202 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.