| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PCI INSURANCE AGENCY3 | 417 WALNUT STREET HARRISBURG, PA 17101 | UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY | $3K | $0 | $3K | 10.99% |
| PCI INSURANCE AGENCY3 Filed as: PCI INSURANCE INC. | 417 WALNUT ST HARRISBURG, PA 17101 | THE GUARDIAN LIFE INSURANCE COMPANY | $5K | $0 | $5K | 26.09% |
| PCI INSURANCE AGENCY3 Filed as: PCI INSURANCE, INC. | 417 WALNUT ST HARRISBURG, PA 17101 | UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY | $1K | $0 | $1K | 10.04% |
| INSURANCE COALITION3 Filed as: INSURANCE COALITION INC | 417 WALNUT STREET HARRISBURG, PA 17101 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 13.54% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC | 422 WAUPONSEE MORRIS, IL 60450 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $0 | $490 | $490 | 4.34% |
| PCI INSURANCE AGENCY3 | 417 WALNUT STREET HARRISBURG, PA 17101 | NATIONAL VISION ADMINISTRATORS | $404 | $0 | $404 | 8.89% |
| PCI INSURANCE AGENCY3 | 417 WALNUT STREET HARRISBURG, PA 17101 | THE GUARDIAN LIFE INSURANCE COMPANY | $1K | $0 | $1K | 37.07% |
| PCI INSURANCE AGENCY3 Filed as: PCI INSURANCE, INC. | 417 WALNUT ST HARRISBURG, PA 17101 | DAVIS VISION | $545 | $0 | $545 | 20.75% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PCI INSURANCE AGENCY EIN 25-1784573 BROKER | Insurance agents and brokers Service code 22 | — | $14K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $9K |
| CAPITAL BLUE CROSS EIN 23-0455154 ADMIN | Claims processing Service code 12 | — | $3K |
| CONNECTCARE 3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $2K |
| HIGHMARK EIN 23-1294723 ADMIN | Claims processing Service code 12 | — | $798 |
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 | 38 | 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) | 38 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts) | UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY | 42 | $40K |
| Vision(2 contracts, 2 carriers) | NATIONAL VISION ADMINISTRATORS | 40 | $7K |
| Life insurance(3 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY | 45 | $35K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY | 20 | $19K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY | 20 | $19K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 38 | $211K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY | 45 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 45 | — |
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.