| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FRISSORA & ASSOCIATES LLC3 Filed as: FRISSORA & ASSOCIATES | 103 BRADFORD RD WEXFORD, PA 15090 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $0 | $0 | 0.00% |
| LILLIS MCKIBBEN BONGIOVANNI AND CO.3 Filed as: LILLIS, MCKIBBEN BONGIOVANNI AND CO | 305 WEST 6TH STREET ERIE, PA 16507 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $457 | $5K | 16.28% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MERITAIN HEALTH EIN 16-1264154 NONE | Claims processing Service code 12 | 300 CORPORATE PARKWAY AMHERST, NY 14226 | $51K |
| FRISSORA & ASSOCIATES EIN 23-0370270 NONE | Contract Administrator Service code 13 | 103 BRADFORD RD WEXFORD, PA 15090 | $30K |
| AMCA EIN 27-4500606 NONE | Claims processing Service code 12 | 101 BRADFORD RD WEXFORD, PA 15090 | $11K |
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 | 143 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 143 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 192 | $30K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 155 | $295K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 192 | $30K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 192 | — |
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.