| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES | 1712 MT. NEBO ROAD SEWICKLEY, PA 16001 | UPMC HEALTH OPTIONS | $68K | — | $68K | 3.01% |
| JAY SHAFFER3 | 422 N MAIN STREET STE D BUTLER, PA 160014360 | METROPOLITAN LIFE INSURANCE COMPANY | $19K | — | $19K | 13.09% |
| SEUBERT & ASSOCIATES, INC.3 | 1010 OHIO RIVER BLVD PITTSBURGH, PA 15202 | GUARDIAN | $6K | $6K | $12K | 8.71% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES | 1712 MT. NEBO ROAD PITTSBURGH, PA 16001 | VISION BENEFITS OF AMERICA | $520 | — | $520 | 1.98% |
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 | 460 | 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) | 460 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UPMC HEALTH OPTIONS | 482 | $2.3M |
| Dental | GUARDIAN | 407 | $133K |
| Vision | VISION BENEFITS OF AMERICA | 394 | $26K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 413 | $275K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 413 | $142K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 413 | $142K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 413 | $142K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 482 | — |
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.