| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEFCHOK & ASSOCIATES3 | 223 W PITTSBURGH ST GREENSBURG, PA 15601 | UPMC HEALTH OPTIONS | $6K | $0 | $6K | 1.05% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | SIX PPG PLACE SUITE 200 PITTSBURGH, PA 15222 | UPMC HEALTH OPTIONS | $4K | $0 | $4K | 0.80% |
| SEFCHOK & ASSOCIATES3 | 223 W PITTSBURGH ST GREENSBURG, PA 15601 | UPMC HEALTH OPTIONS | $3K | $0 | $3K | 1.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | SIX PPG PLACE SUITE 200 PITTSBURGH, PA 15222 | UPMC HEALTH OPTIONS | $2K | $0 | $2K | 0.83% |
| GARY S SEFCHOK3 | 223 W PITTSBURGH ST GREENSBURG, PA 15601 | DEARBORN LIFE INSURANCE COMPANY | $5K | $0 | $5K | 8.02% |
| DANIEL J MAJERNIK3 | SIX PPG PLACE SUITE 200 PITTSBURGH, PA 15222 | DEARBORN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 3.70% |
| EMERSON REID LLC3 | 1305 WALT WHITMAN RD STE 310 MELVILLE, NY 11747 | AMERITAS LIFE INSURANCE CORP | $3K | $0 | $3K | 5.00% |
| ENGLE-HAMBRIGHT & DAVIES, INC.3 Filed as: ENGLE HAMBRIGHT & DAVIES | PO BOX 11600 1857 WILLIAM PENN WAY LANCASTER, PA 17601 | AMERITAS LIFE INSURANCE CORP | $2K | $0 | $2K | 3.55% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES INC | SIX PPG PLACE SUITE 200 PITTSBURGH, PA 15222 | AMERITAS LIFE INSURANCE CORP | $672 | $0 | $672 | 1.21% |
| WILLIAM S. LAW3 Filed as: WILLIAM S LAW | 600 KINGFRED DRIVE HUNTINGTON, PA 15642 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $395 | $0 | $395 | 3.03% |
| PETERSON FINANCIAL INC3 | 548 CANTON ROAD WINTERSVILLE, OH 43953 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $388 | $0 | $388 | 2.98% |
| GARY S SEFCHOK3 | 223 W PITTSBURGH ST GREENSBURG, PA 15601 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $323 | $0 | $323 | 2.48% |
| CBF BENEFITS INC3 | 1309 HIDDEN HARBOR ROAD MYRTLE BEACH, SC 29577 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $212 | $20 | $232 | 1.78% |
| NORTHWEST ENROLLX LLC3 | 7656 TWP ROAD 94 FINDLAY, OH 45840 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $177 | $22 | $199 | 1.53% |
| NORTHWEST WORKSITE MARKETING CORP3 | 1910 INDIAN WOOD CIRCLE MAUMEE, OH 43537 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $170 | $1 | $171 | 1.31% |
| DONNA TROXELL3 | 706 WESTWOOD DRIVE GIBSONIA, PA 15044 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3 | $3 | $6 | 0.05% |
| TIMOTHY BIRDSONG3 | 302 FIELDBROOK DRIVE WASHINGTON, PA 15301 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3 | $2 | $5 | 0.04% |
| SEFCHOK & ASSOCIATES3 | 233 W PITTSBURGH ST GREENSBURG, PA 15601 | UPMC HEALTH BENEFITS | $304 | $0 | $304 | 2.40% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | SIX PPG PLACE SUITE 200 PITTSBURGH, PA 15222 | UPMC HEALTH BENEFITS | $162 | $0 | $162 | 1.28% |
| SEFCHOK & ASSOCIATES3 | 233 W PITTSBURGH ST GREENSBURG, PA 15601 | UPMC HEALTH OPTIONS | $162 | $0 | $162 | 1.41% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 6 PPG PLACE STE 200 PITTSBURGH, PA 15222 | UPMC HEALTH OPTIONS | $56 | $0 | $56 | 0.49% |
| SEFCHOK & ASSOCIATES3 | 233 W PITTSBURGH ST GREENSBURG, PA 15601 | UPMC HEALTH OPTIONS | $12 | $0 | $12 | 1.98% |
| SEFCHOK & ASSOCIATES3 | 223 W PITTSBURGH ST GREENSBURG, PA 15601 | UPMC HEALTH BENEFITS | $8 | $0 | $8 | 2.56% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | SIX PPG PLACE SUITE 200 PITTSBURGH, PA 15222 | UPMC HEALTH BENEFITS | $3 | $0 | $3 | 0.96% |
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 | 130 | 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) | 130 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts) | UPMC HEALTH OPTIONS | 69 | $823K |
| Dental | AMERITAS LIFE INSURANCE CORP | 290 | $55K |
| Vision(2 contracts) | UPMC HEALTH BENEFITS | 241 | $13K |
| Life insurance(2 contracts, 2 carriers) | DEARBORN LIFE INSURANCE COMPANY | 130 | $79K |
| Short-term disability | DEARBORN LIFE INSURANCE COMPANY | 130 | $66K |
| Long-term disability | DEARBORN LIFE INSURANCE COMPANY | 130 | $66K |
| Other(2 contracts, 2 carriers) | DEARBORN LIFE INSURANCE COMPANY | 130 | $79K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 290 | — |
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."
No prospect flags tripped on this filing.