| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEUBERT & ASSOCIATES, INC.3 | 225 NORTH SHORE DRIVE SUITE 300 PITTSBURGH, PA 15212 | HIGHMARK, INC. | $38K | — | $38K | 3.20% |
| ENROLLMENT BENEFIT CONCEPTS LLC3 Filed as: ENROLLMENT BENEFIT CONCEPTS, LLC | 100 OTTAWA AVE. SW GRAND RAPIDS, MI 49503 | CONTINENTAL AMERICAN INSURANCE COMPANY | $8K | — | $8K | 8.95% |
| TRACEY HINRICHS3 | 55 MIDWAY ISLAND CLEARWATER, FL 33767 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6K | — | $6K | 7.09% |
| SEUBERT & ASSOCIATES, INC.3 | 225 NORTH SHORE DRIVE STE 300 PITTSBURGH, PA 15212 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6K | — | $6K | 6.87% |
| THE DJB GROUP3 Filed as: THE DJB GROUP, INC. | 262 CHESTNUT STREET STE 200 MEADVILLE, PA 16335 | CONTINENTAL AMERICAN INSURANCE COMPANY | $480 | — | $480 | 0.54% |
| ALYNN G CERVONE3 Filed as: ALYNN GRACE CERVONE | 14220 CRESCENT LANE MEADVILLE, PA 16335 | CONTINENTAL AMERICAN INSURANCE COMPANY | $59 | — | $59 | 0.07% |
| SMITH BENEFITS CONSULTING GROUP3 | 243 TAMARACK DR. STE 230 MARS, PA 16046 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5 | — | $5 | 0.01% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC. | 225 N SHORE DRIVE. STE 300 PITTSBURGH, PA 15212 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 5.30% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC. | 225 WIRELESS BLVD. STE 200 HAUPPAUGE, NY 11788 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $2K | $4K | 5.00% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC. | 225 WIRELESS BLVD. STE 200 HAUPPAUGE, NY 11788 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | $515 | $4K | 5.72% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC. | 225 N SHORE DRIVE. STE 300 PITTSBURGH, PA 15212 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | — | $3K | 4.54% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC. | 225 N SHORE DRIVE. STE 300 PITTSBURGH, PA 15212 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 12.00% |
| PROFESSIONAL GROUP PLAN INC3 Filed as: PROFESSIONAL GROUP PLAN | 225 WIRELESS BLVD. STE 200 HAUPPAUGE, NY 11788 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $801 | $706 | $2K | 5.00% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES | 225 NORTH SHORE DR. STE 300 PITTSBURGH, PA 15212 | VISION BENEFITS OF AMERICA | $942 | — | $942 | 7.04% |
| MANUFACTURER & BUSINESS ASSOCIATION3 Filed as: MANUFACTURER & BUSINESS ASSN. | 2171 WEST 38TH STREET ERIE, PA 16508 | VISION BENEFITS OF AMERICA | $265 | — | $265 | 1.98% |
| THE DJB GROUP3 Filed as: THE DJB GROUP INC. | 262 CHESTNUT STREET STE 200 MEADVILLE, PA 16335 | VISION BENEFITS OF AMERICA | $265 | — | $265 | 1.98% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES | 225 NORTH SHORE DR. STE 300 PITTSBURGH, PA 15212 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 10.00% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS | 225 WIRELESS BLVD. STE 200 HAUPPAUGE, NY 11788 | LIFE INSURANCE COMPANY OF NORTH AMERICA | -$191 | $832 | $641 | 5.00% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC. | 225 N SHORE DRIVE. STE 300 PITTSBURGH, PA 15212 | VISION BENEFITS OF AMERICA | $296 | — | $296 | 4.21% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC. | 225 N SHORE DRIVE. STE 300 PITTSBURGH, PA 15212 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $558 | — | $558 | 9.99% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC. | 225 WIRELESS BLVD. STE 200 HAUPPAUGE, NY 11788 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $148 | $131 | $279 | 5.00% |
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 | 225 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 226 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK, INC. | 273 | $1.2M |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 147 | $70K |
| Vision(2 contracts) | VISION BENEFITS OF AMERICA | 219 | $20K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $13K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $73K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $30K |
| Prescription drug | HIGHMARK, INC. | 273 | $313K |
| Other(2 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 48 | $95K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 273 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.