| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COMMONWEALTH FINANCIAL GROUP3 | 2 BARCLO CIRCLE, SUITE 3 DILLSBURG, PA 17019 | UNITED CONCORDIA INSURANCE COMPANIES, INC. | $2K | $0 | $2K | 5.52% |
| MPB RISK SERVICES LLC3 | 2407 PARK DR HARRISBURG, PA 17110 | UNITED CONCORDIA INSURANCE COMPANIES, INC. | $2K | $0 | $2K | 5.25% |
| COMMONWEALTH FINANCIAL GROUP3 Filed as: COMMONWEALTH FINANCIAL GROUP INC | 2 BARLO CIRCLE, SUITE C DILLSBURG, PA 17019 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 13.72% |
| MPB RISK SERVICES LLC3 | 2407 PARK DR HARRISBURG, PA 17110 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $207 | $0 | $207 | 1.28% |
| COMMONWEALTH FINANCIAL GROUP3 Filed as: COMMONWEALTH FINANCIAL GROUP INC | 2 BARLO CIRCLE, SUITE C DILLSBURG, PA 17019 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 13.65% |
| MPB RISK SERVICES LLC3 | 2407 PARK DR HARRISBURG, PA 17110 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $116 | $0 | $116 | 1.35% |
| BRADLY GRAFFIUS3 | 2 BARLO CIR STE C DILLSBURG, PA 17019 | HIGHMARK, INC. | $220 | $0 | $220 | 3.96% |
| THE BENECON GROUP3 Filed as: THE BENECON GROUP, LLC | PO BOX 5406 LANCASTER, PA 17606 | HIGHMARK, INC. | $110 | $0 | $110 | 1.98% |
| COMMONWEALTH FINANCIAL GROUP3 Filed as: COMMONWEALTH FINANCIAL GROUP INC | 2 BARLO CIRCLE, SUITE C DILLSBURG, PA 17019 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $481 | $0 | $481 | 13.73% |
| MPB RISK SERVICES LLC3 | 2407 PARK DR HARRISBURG, PA 17110 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $44 | $0 | $44 | 1.26% |
| COMMONWEALTH FINANCIAL GROUP3 Filed as: COMMONWEALTH FINANCIAL GROUP INC | 2 BARLO CIRCLE, SUITE C DILLSBURG, PA 17019 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $220 | $0 | $220 | 13.68% |
| MPB RISK SERVICES LLC3 | 2407 PARK DR HARRISBURG, PA 17110 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $21 | $0 | $21 | 1.31% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $16K |
| COMMONWEALTH FINANCIAL GROUP EIN 23-2399040 BROKER | Insurance agents and brokers Service code 22 | — | $15K |
| MPB RISK SERVICES, LLC EIN 85-0556241 BROKER | Insurance agents and brokers Service code 22 | — | $8K |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $3K |
| CAPITAL BLUECROSS EIN 23-0455154 CARRIER | Claims processing Service code 12 | — | -$13K |
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 | 63 | 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) | 63 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED CONCORDIA INSURANCE COMPANIES, INC. | 100 | $34K |
| Vision | HIGHMARK, INC. | 94 | $6K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 63 | $2K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 63 | $9K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 63 | $16K |
| Stop-loss / reinsurancereinsurance | OPTUM HEALTH (UNIMERICA INSURANCE COMPANY) | 55 | $287K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 63 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 100 | — |
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."
No prospect flags tripped on this filing.