| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TENTH DOT BENEFITS SOLUTIONS LLC3 Filed as: TENTH DOT BENEFITS SOLUTIONS, LLC | 4 GATEWAY CENTER, SUITE 750 444 LIBERTY AVE. PITTSBURGH, PA 15222 | HEALTHAMERICA OF PENNSYLVANIA, INC. | $30K | — | $30K | 2.00% |
| BENEFITS NETWORK INC. (WEXFORD,PA)3 Filed as: BENEFITS NETWORK, INC. | NORTHRIDGE OFFICE PLAZA II, #12 115 VIP DRIVE WEXFORD, PA 15090 | HEALTHAMERICA OF PENNSYLVANIA, INC. | — | — | $0 | 0.00% |
| TENTH DOT BENEFITS SOLUTIONS LLC3 | FOUR GATEWAY CENTER, SUITE 750 444 LIBERTY AVENUE PITTSBURGH, PA 15222 | AETNA LIFE INSURANCE CO. | $2K | — | $2K | 2.30% |
| TENTH DOT BENEFITS SOLUTIONS LLC3 Filed as: TENTH DOT BENEFITS SOLUTIONS, LLC | 4 GATEWAY CENTER, SUITE 750 PITTSBURGH, PA 15222 | LINCOLN NATIONAL LIFE INSURANCE CO. | $4K | — | $4K | 10.02% |
| TENTH DOT BENEFITS SOLUTIONS LLC3 Filed as: TENTH DOT BENEFITS SOLUTIONS, LLC | 4 GATEWAY CENTER, SUITE 750 444 LIBERTY AVE. PITTSBURGH, PA 15222 | HIGHMARK | $829 | — | $829 | 3.70% |
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 | 373 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 373 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTHAMERICA OF PENNSYLVANIA, INC. | 373 | $1.5M |
| Dental | AETNA LIFE INSURANCE CO. | 361 | $81K |
| Vision | HIGHMARK | 296 | $22K |
| Long-term disability | LINCOLN NATIONAL LIFE INSURANCE CO. | 73 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 373 | — |
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.