| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LIBERTY INSURANCE SERVICES3 | 1910 COCHRAN ROAD MANOR OAK TWO, SUITE 800 PITTSBURGH, PA 15220 | UPMC HEALTH OPTIONS | $35K | — | $35K | 2.25% |
| DAN DESTEFANO3 | C/O LIBERTY INSURANCE AGENCY 1910 COCHRAN ROAD SUITE 800 PITTSBURGH, PA 15220 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | — | $6K | 9.51% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONESE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $575 | $3K | 6.04% |
| LIBERTY FINANCIAL SERVICES3 Filed as: LIBERTY FINANCIAL SERVICES INC | 1910 COCHRAN ROAD MANOR OAK TWO, SUITE 800 PITTSBURGH, PA 15220 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 4.80% |
| DAN DESTEFANO3 | 128 GOLFVIEW DRIVE MCMURRAY, PA 15317 | VISION BENEFITS OF AMERICA | $400 | — | $400 | 3.50% |
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 | 169 | 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) | 169 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UPMC HEALTH OPTIONS | 335 | $1.6M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 338 | $55K |
| Vision | VISION BENEFITS OF AMERICA | 334 | $11K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 91 | $66K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 91 | $66K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 91 | $66K |
| Prescription drug | UPMC HEALTH OPTIONS | 335 | $1.6M |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 91 | $66K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 338 | — |
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.