| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KEYSTONE INS & BNFTS GRP LLC3 Filed as: KEYSTONE INS & BNFTS GRP, LLC | 13800 JACKSON RD MISHAWAKA, IN 46544 | UNITEDHEALTHCARE INSURANCE COMPANY | $31K | — | $31K | 2.99% |
| BUSINESS DISTRIBUTION SOLUTIONS3 | 4400 TIMBER COMMONS DR SANDUSKY, OH 44870 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $6K | $6K | 0.62% |
| KEYSTONE INS & BFTS GRP LLC3 Filed as: KEYSTONE INS & BEN GROUP | 1995 CROWN POINT DRIVE NORTHUMBERLAND, PA 17857 | HEALTH RESOURCES, INC. | $6K | — | $6K | 10.00% |
| KEYSTONE INS & BNFTS GRP LLC3 Filed as: KEYSTONE INS & BNFTS GRP, LLC | 1995 POINT TOWNSHIP DR NORTHUMBERLAND, PA 17857 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $406 | $3K | 15.47% |
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 | 132 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 132 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 186 | $1.0M |
| Dental | HEALTH RESOURCES, INC. | 187 | $56K |
| Vision | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 132 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 187 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.