| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMERICAN INSURANCE ADMINISTRATORS3 | 4550 LENA DRIVE MECHANICSBURG, PA 17055 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $31K | $0 | $31K | 2.31% |
| USI INSURANCE SERVICES LLC3 | 1 INTERNATIONAL PLAZA, 4TH FLOOR PHILADELPHIA, PA 19113 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $15K | $0 | $15K | 1.15% |
| ASSUREDPARTNERS3 Filed as: INGROUP ASSOCIATES | UNKNOWN LANCASTER, PA 17601 | UNITED CONCORDIA INSURANCE COMPANY | $4K | $0 | $4K | 5.08% |
| BENEFIT ADVISORS NETWORK LLC3 Filed as: BENEFIT ADVISORS NETWORK | UNKNOWN BEACHWOOD, OH 44122 | UNITED CONCORDIA INSURANCE COMPANY | $0 | $1K | $1K | 2.00% |
| USI INSURANCE SERVICES LLC3 | UNKNOWN VIRGINIA BEACH, VA 23466 | UNITED CONCORDIA INSURANCE COMPANY | $0 | $288 | $288 | 0.42% |
| ASSUREDPARTNERS3 Filed as: INGROUP ASSOCIATES INC | 448 MURRY HILL CIRCLE LANCASTER, PA 17601 | HARTFORD LIFE AND ACCIDENT | $2K | $411 | $3K | 4.96% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $1K | $0 | $1K | 2.48% |
| ASSUREDPARTNERS3 Filed as: INGROUP ASSOCIATES INC | 448 MURRY HILL CIRCLE LANCASTER, PA 17601 | VISION SERVICE PLAN | $898 | $0 | $898 | 4.16% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $602 | $0 | $602 | 2.79% |
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 | 120 | 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) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CAPITAL ADVANTAGE ASSURANCE COMPANY | 200 | $1.3M |
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 252 | $69K |
| Vision | VISION SERVICE PLAN | 147 | $22K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 172 | $53K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 172 | $53K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 172 | $53K |
| Prescription drug | CAPITAL ADVANTAGE ASSURANCE COMPANY | 200 | $1.3M |
| Other | HARTFORD LIFE AND ACCIDENT | 172 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 252 | — |
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.