| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITS NETWORK INC. (WEXFORD,PA)3 Filed as: BENEFITS NETWORK, INC. | 115 VIP DRIVE, SUITE 300 WEXFORD, PA 15090 | UPMC HEALTH OPTIONS | $11K | $0 | $11K | 2.60% |
| BENEFITS NETWORK INC. (WEXFORD,PA)3 Filed as: BENEFITS NETWORK, INC. | 115 VIP DRIVE, SUITE 300 WEXFORD, PA 15090 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $0 | $5K | 12.83% |
| ROBERT J ELBIN JR3 Filed as: ROBERT J. ELBIN JR. | 430 FORBES ROAD BEDFORD, PA 15522 | AFLAC | $2K | $0 | $2K | 8.88% |
| MJ INSURANCE3 Filed as: DANIAL R. JUDY AND VARIOUS AGENTS | 231 WALTERS MILL ROAD SOMERSET, PA 15501 | AFLAC | $379 | $0 | $379 | 2.07% |
| SHAYNE L BRANDENBURG3 Filed as: SHAYNE L. BRANDENBURG | 17765 ROUTE 954 HIGHWAY NORTH HOME, PA 15747 | AFLAC | $338 | $0 | $338 | 1.84% |
| JOHN E HRIVNAK3 Filed as: JOHN E. HRIVNAK | 3900 INDUSTRIAL PARK DRIVE SUITE 11 ALTOONA, PA 16602 | AFLAC | $226 | $0 | $226 | 1.23% |
| MICHAEL H FLEMING3 Filed as: MICHAEL H. FLEMING | 7546 STATE ROUTE 30, 3RD FLOOR IRWIN, PA 15642 | AFLAC | $213 | $0 | $213 | 1.16% |
| DONALD J MASON3 Filed as: DONALD J. MASON | 321 NIVER JUNCTION ROAD BERLIN, PA 15530 | AFLAC | $117 | $0 | $117 | 0.64% |
| JENNIFER ROBIN HRIVNAK3 | 3900 INDUSTRIAL PARK DRIVE SUITE 11 ALTOONA, PA 16602 | AFLAC | $90 | $0 | $90 | 0.49% |
| BENEFITS NETWORK INC. (WEXFORD,PA)3 Filed as: BENEFITS NETWORK, INC. | 115 VIP DRIVE, SUITE 300 WEXFORD, PA 15090 | UNITED CONCORDIA INSURANCE COMPANY | $3K | $0 | $3K | 15.94% |
| BENEFITS NETWORK INC. (WEXFORD,PA)3 Filed as: BENEFITS NETWORK, INC. | 115 VIP DRIVE, SUITE 300 WEXFORD, PA 15090 | UPMC HEALTH BENEFITS | $231 | $0 | $231 | 4.02% |
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 | 178 | 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) | 178 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UPMC HEALTH OPTIONS | 129 | $414K |
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 130 | $18K |
| Vision(2 contracts, 2 carriers) | UPMC HEALTH OPTIONS | 129 | $414K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 178 | $41K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 178 | $41K |
| Prescription drug(2 contracts, 2 carriers) | UPMC HEALTH OPTIONS | 129 | $414K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 178 | $60K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 178 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.