| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | — | $5K | 5.99% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 4.22% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $760 | — | $760 | 10.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B STREET, 6TH STREET SAN DIEGO, CA 92101 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $680 | — | $680 | 10.00% |
| ROBERT SHEESLEY4 | 380 OCEAN RD, UNIT 6 PORTSMOUTH, NH 03801 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $257 | — | $257 | 20.24% |
| KENNETH HART4 | 250 MEADOWSWEET DR STATE COLLEGE, PA 16801 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $36 | — | $36 | 2.83% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $157K |
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 | 560 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 9 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 582 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF PENNSYLVANIA | 379 | $252K |
| Vision | VISION BENEFITS OF AMERICA | 225 | $26K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 462 | $79K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 560 | $80K |
| Other(4 contracts, 3 carriers) | VISION BENEFITS OF AMERICA | 462 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 560 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.