| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FIRST NATIONAL INSURANCE AGENCY3 Filed as: FIRST NATIONAL INSURANCE AGENCY LLC | 12 FEDERAL STREET SUITE 405 PITTSBURGH, PA 15215 | UNITED CONCORDIA LIFE & HEALTH INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HIGHMARK, INC. EIN 23-1294723 NONE | Insurance services; Other insurance fees and expenses Service code 23 | FIFTH AVENUE PLACE 120 FIFTH AVE PITTSBURGH, PA 15222 | $822K |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 NONE | Contract Administrator Service code 13 | 151 FARMINGTON AVENUE HARTFORD, CT 06156 | $369K |
| LIBERTY LIFE ASSURANCE CO OF BOSTON EIN 04-6076039 NONE | Contract Administrator; Insurance services; Claims processing Service code 12 | P.O. BOX 2658 CAROL STREAM, IL 60123 | $126K |
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 | 3,823 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 167 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,990 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED CONCORDIA LIFE & HEALTH INSURANCE COMPANY | 5,300 | $1.4M |
| Vision(2 contracts) | COMBINED INSURANCE COMPANY OF AMERICA | 5,603 | $319K |
| Life insurance | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 3,148 | $803K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 3,108 | $395K |
| Other | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 3,148 | $803K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,603 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.