| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MICHAEL P WALTON3 | 361 SAWMILL RD DILLSBURG, PA 17019 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 12.07% |
| NY LIFE SECURITIES LLC3 | 51 MADISON AVE RM 125 NEW YORK, NY 10010 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $269 | $269 | 0.75% |
| MICHAEL P WALTON3 | 361 SAWMILL RD DILLSBURG, PA 17019 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $133 | $0 | $133 | 10.36% |
| NY LIFE SECURITIES LLC3 | 51 MADISON AVE RM 125 NEW YORK, NY 10010 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $26 | $26 | 2.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMONWEALTH BENEFITS GROUP BROKER | Insurance agents and brokers Service code 22 | 2 BARLOW CIR # C DILLSBURG, PA 17019 | $16K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $11K |
| CAPITAL BLUE CROSS EIN 23-0455154 ADMIN | Claims processing Service code 12 | — | $5K |
| CONNECTCARE 3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $2K |
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 | 43 | 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) | 43 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNUM LIFE INSURANCE COMPANY OF AMERICA | 28 | $1K |
| Vision | UNUM LIFE INSURANCE COMPANY OF AMERICA | 28 | $1K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 43 | $36K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 43 | $36K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 43 | $36K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 35 | $107K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 43 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 43 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.