| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AP BENEFITS ADVISORS LLC3 | 10 N PARK DR #200 HUNT VALLEY, MD 21030 | DELTA DENTAL OF PENNSYLVANIA | $3K | $0 | $3K | 10.00% |
| LY, KIM L3 | 39 N DUKE ST LANCASTER, PA 17602 | HIGHMARK, INC. | $291 | $0 | $291 | 5.79% |
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | 200 INTERNATIONAL CR STE 4500 HUNT VALLEY, MD 21031 | HIGHMARK, INC. | $17 | $0 | $17 | 0.34% |
| AP BENEFIT ADVISORS, LLC3 Filed as: AP BENEFIT ADVISORS LLC | 10 N PARK DR #200 HUNT VALLEY, MD 21030 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $260 | $76 | $336 | 19.41% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $42 | $42 | 2.43% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HIGHMARK BCBS NEPA EIN 23-2413324 ADMIN | Claims processing Service code 12 | — | $22K |
| THE BENECON GROUP LLC EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $13K |
| ASSURED PARTNERS (CENTRAL PA) EIN 30-0837157 BROKER | Insurance agents and brokers Service code 22 | — | $13K |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $3K |
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 | 57 | 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) | 57 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF PENNSYLVANIA | 89 | $28K |
| Vision | HIGHMARK, INC. | 72 | $5K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 66 | $2K |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 52 | $172K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 66 | $2K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 89 | — |
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.