| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC. | 225 NORTH SHORE DRIVE STE 300 PITTSBURGH, PA 15212 | HIGHMARK, INC. | $52K | — | $52K | 2.50% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC. | 225 NORTH SHORE DRIVE STE 300 PITTSBURGH, PA 15212 | HIGHMARK, INC. | $21K | — | $21K | 2.50% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC. | 225 NORTH SHORE DRIVE STE 300 PITTSBURGH, PA 15212 | HIGHMARK, INC. | $20K | — | $20K | 15.00% |
| JAY G SHAFFER3 | 422 N MAIN STREET STE D BUTLER, PA 16001 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $9K | — | $9K | 7.00% |
| JAY G SHAFFER3 | 422 N MAIN STREET STE D BUTLER, PA 16001 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $10K | — | $10K | 15.00% |
| JAY G SHAFFER3 | 422 N MAIN STREET STE D BUTLER, PA 16001 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | — | $5K | 7.75% |
| JAY G SHAFFER3 | 422 N MAIN STREET STE D BUTLER, PA 16001 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 8.85% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES | 225 NORTH SHORE DRIVE SUITE 300 PITTSBURGH, PA 15212 | VISION BENEFITS OF AMERICA | $1K | — | $1K | 4.81% |
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 | 432 | 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) | 432 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK, INC. | 363 | $2.1M |
| Dental | HIGHMARK, INC. | 452 | $132K |
| Vision | VISION BENEFITS OF AMERICA | 349 | $25K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 432 | $92K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 302 | $124K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 365 | $59K |
| Prescription drug | HIGHMARK, INC. | 363 | $834K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 432 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 452 | — |
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.