| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC. | 225 N SHORE DRIVE STE 300 PITTSBURGH, PA 15212 | HIGHMARK, INC. | $30K | — | $30K | 2.75% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC. | 225 N SHORE DRIVE STE 300 PITTSBURGH, PA 15212 | STARMOUNT LIFE INSURANCE COMPANY | $10K | $230 | $10K | 11.41% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC. | 225 N SHORE DRIVE STE 300 PITTSBURGH, PA 15212 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $106 | $6K | 12.25% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC. | 225 N SHORE DRIVE STE 300 PITTSBURGH, PA 15212 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $82 | $5K | 16.21% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC. | 225 N SHORE DRIVE STE 300 PITTSBURGH, PA 15212 | UNUM INSURANCE COMPANY | $3K | $330 | $3K | 16.82% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC. | 225 N SHORE DRIVE STE 300 PITTSBURGH, PA 15212 | UNUM INSURANCE COMPANY | $2K | $218 | $2K | 14.15% |
| SEUBERT & ASSOCIATES, INC.3 Filed as: SEUBERT & ASSOCIATES INC. | 225 N SHORE DRIVE STE 300 PITTSBURGH, PA 15212 | UNUM INSURANCE COMPANY | $2K | $35 | $2K | 16.35% |
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 | 128 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 131 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK, INC. | 300 | $1.1M |
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 125 | $88K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 125 | $88K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 128 | $82K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 128 | $48K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 128 | $48K |
| Prescription drug | HIGHMARK, INC. | 210 | $208K |
| Other(5 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 128 | $127K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 300 | — |
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.