| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC. | 225 NORTH SHORE DR. STE 300 PITTSBURGH, PA 15212 | UPMC HEALTH OPTIONS | $20K | — | $20K | 2.49% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC. | 225 NORTH SHORE DR. STE 300 PITTSBURGH, PA 15212 | UPMC HEALTH BENEFITS | $5K | — | $5K | 10.03% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC. | 225 NORTH SHORE DR. STE 300 PITTSBURGH, PA 15212 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $328 | $5K | 12.28% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC. | 225 NORTH SHORE DR. STE 300 PITTSBURGH, PA 15212 | VISION BENEFITS OF AMERICA | $276 | — | $276 | 3.00% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC. | 225 NORTH SHORE DR. STE 300 PITTSBURGH, PA 15212 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $905 | — | $905 | 14.04% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC. | 225 NORTH SHORE DR. STE 300 PITTSBURGH, PA 15212 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $523 | $26 | $549 | 16.30% |
| RUTH E WOODS3 | 147 HEMPHILL ST. PITTSBURGH, PA 15214 | AFLAC | $67 | — | $67 | 4.19% |
| KENNETH W SIMON3 | 111 WHITE OAK DR. MCKEESPORT, PA 15131 | AFLAC | $24 | — | $24 | 1.50% |
| DAVID CLARK3 | 510 FAIR VISTA CT. WEXFORD, PA 15090 | AFLAC | $23 | — | $23 | 1.44% |
| ROBERT PAUL STINE3 | 19 AMY LYNE DR. SMITHFIELD, PA 15478 | AFLAC | $20 | — | $20 | 1.25% |
| BRIAN W PATTEN3 | 120 MARGUERITE DR. STE 101 CRANBERRY TOWNSHIP, PA 16066 | AFLAC | $13 | — | $13 | 0.81% |
| ROBERT RICHARD ARETTA3 | PO BOX 211 HUNKER, PA 15639 | AFLAC | $11 | — | $11 | 0.69% |
| KRISTIN J QUINLAN3 | 137 SEMICONON LN. RENFREW, PA 16053 | AFLAC | $8 | — | $8 | 0.50% |
| DAVID K AGARWAL3 | PO BOX 700472 SAINT CLOUD, FL 34770 | AFLAC | $6 | — | $6 | 0.38% |
| BLACK ROK BENEFIT ALLIANCE LLC3 | PO BOX 211 YOUNGWOOD, PA 15697 | AFLAC | $6 | — | $6 | 0.38% |
| TIMOTHY R QUINLAN3 | 137 SEMICONON LN RENFREW, PA 16053 | AFLAC | $2 | — | $2 | 0.13% |
| KIMMON R GUSEMAN3 | 47 E FAYETTE ST. UNIT 259 UNIONTOWN, PA 15401 | AFLAC | $1 | — | $1 | 0.06% |
| SHARON R GRANT3 | 96 SILVER OAKS CIRCLE UNIT 1104 NAPLES, FL 34119 | AFLAC | $1 | — | $1 | 0.06% |
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 | 150 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 155 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UPMC HEALTH OPTIONS | 153 | $819K |
| Dental | UPMC HEALTH BENEFITS | 169 | $49K |
| Vision | VISION BENEFITS OF AMERICA | 100 | $9K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 150 | $47K |
| Short-term disability(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 18 | $8K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 150 | $43K |
| Prescription drug | UPMC HEALTH OPTIONS | 153 | $817K |
| Other(4 contracts, 3 carriers) | UPMC HEALTH OPTIONS | 153 | $866K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 169 | — |
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.