| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOESEL-SCHAAF INSURANCE AGENCY INC3 Filed as: LOESEL-SCHAAF INSURANACE AGENCY INC | 3537 W. 12TH STREET ERIE, PA 16505 | HIGHMARK CASUALTY INSURANCE COMPANY | $22K | — | $22K | 6.00% |
| BARTLETT INSURANCE GROUP LLC3 Filed as: BARTLETT INSURANCE GROUP, INC. | P.O. BOX 8442 804 WEST BARTLETT ROAD BARTLETT, IL 60103 | HCC LIFE INSURANCE COMPANY | $12K | — | $12K | 10.00% |
| BARTLETT INSURANCE GROUP LLC3 Filed as: BARTLETT INSURANCE GROUP, LLC | P.O. BOX 8442 804 WEST BARTLETT ROAD BARTLETT, IL 60103 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 6.24% |
| LOESEL-SCHAAF INSURANCE AGENCY INC3 Filed as: LOESEL-SCHAAF INSURANACE AGENCY INC | 3537 W. 12TH STREET ERIE, PA 16505 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $2K | $5K | 8.27% |
| LOESEL-SCHAAF INSURANCE AGENCY INC3 Filed as: LOESEL-SCHAAF INSURANACE AGENCY INC | 3537 W. 12TH STREET ERIE, PA 16505 | VISION BENEFITS OF AMERICA | $2K | — | $2K | 4.35% |
| BARTLETT INSURANCE GROUP LLC3 Filed as: BARTLETT INSURANCE GROUP, INC. | P.O. BOX 8442 804 WEST BARTLETT ROAD BARTLETT, IL 60103 | DELTA DENTAL OF ILLINOIS | $2K | — | $2K | 7.98% |
| LOESEL-SCHAAF INSURANCE AGENCY INC3 Filed as: LOESEL-SCHAAF INSURANACE AGENCY INC | 3537 W. 12TH STREET ERIE, PA 16505 | SUN LIFE ASSURANCE COMPANY OF CANADA | $272 | — | $272 | 6.84% |
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 | 406 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 77 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 483 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HIGHMARK CASUALTY INSURANCE COMPANY | 274 | $495K |
| Dental | DELTA DENTAL OF ILLINOIS | 369 | $20K |
| Vision | VISION BENEFITS OF AMERICA | 300 | $37K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 433 | $62K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 168 | $74K |
| Stop-loss / reinsurancereinsurance | HIGHMARK CASUALTY INSURANCE COMPANY | 274 | $374K |
| Other(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 620 | $66K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 620 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.