| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCBANE INSURANCE AND FINANCIAL SERV3 | P.O. BOX 2609 WINTERSVILLE, OH 43953 | ANTHEM LIFE INSURANCE COMPANY | $15K | — | $15K | 9.78% |
| HM CENTERED HEALTH INC0 Filed as: HM CENTERED HEALTH, INC. | 19 NORTH MAIN STREET WILKES BARRE, PA 18711 | FOUR EVER LIFE INS. CO. | $0 | $149 | $149 | 4.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CBIZ, INC. EIN 22-2769024 ADMIN/CONSULTANT FEES | Contract Administrator; Consulting fees Service code 13 | 6050 OAK TREE BLVD. S., SUITE 500 CLEVELAND, OH 44131 | $69K |
| HIGHMARK EIN 23-1294723 ADMINISTRATIVE FEES | Contract Administrator Service code 13 | — | $41K |
| CATHOLIC BENEFIT TRUST EIN 34-7208299 OTHER | Other fees Service code 99 | — | $30K |
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 | 370 | 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) | 370 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | FOUR EVER LIFE INS. CO. | 2 | $4K |
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 617 | $123K |
| Vision | VISION BENEFITS OF AMERICA | 309 | $45K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 354 | $149K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 354 | $149K |
| Prescription drug | FOUR EVER LIFE INS. CO. | 2 | $4K |
| Other | ANTHEM LIFE INSURANCE COMPANY | 354 | $149K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 617 | — |
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."
No prospect flags tripped on this filing.