| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES | 225 NORTH SHORE DRIVE SUITE 300 PITTSBURGH, PA 15212 | UPMC HEALTH OPTIONS | $68K | — | $68K | 2.82% |
| SEUBERT & ASSOCIATES, INC.3 | 225 N SHORE DRIVE SUITE 300 PITTSBURGH, PA 152125860 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $34 | $6K | 3.55% |
| JAY SHAFFER3 | 422 N MAIN STREET STE D BUTLER, PA 160014360 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 1.18% |
| JAY G SHAFFER3 | 422 N MAIN STREET BUTLER, PA 16001 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | — | $7K | 7.00% |
| JAY G SHAFFER3 | 422 N MAIN STREET BUTLER, PA 16001 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 9.12% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES | 225 NORTH SHORE DRIVE SUITE 300 PITTSBURGH, PA 15212 | VISION BENEFITS OF AMERICA | $1K | — | $1K | 4.30% |
| JAY G SHAFFER3 | 422 N MAIN STREET BUTLER, PA 16001 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| JAY G SHAFFER3 | 422 N MAIN STREET BUTLER, PA 16001 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 9.11% |
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 | 524 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 533 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UPMC HEALTH OPTIONS | 486 | $2.4M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 615 | $161K |
| Vision | VISION BENEFITS OF AMERICA | 458 | $30K |
| Life insurance(3 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 615 | $212K |
| Short-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 615 | $262K |
| Long-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 615 | $209K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 615 | $185K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 615 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.