| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COMMONWEALTH FINANCIAL GROUP3 | 2 BARLO CIRCLE SUITE B DILLSBURG, PA 17019 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $290 | $3K | 7.30% |
| INDEPENDENCE PLANNING GROUP3 | 1767 SENTRY PKWY W BLUE BELL, PA 19422 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $12 | $0 | $12 | 0.03% |
| MAZZMAR LLC3 Filed as: MAZZMAR | 1767 SENTRY PARKWAY WEST, SUITE 200 BLUE BELL, PA 19422 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8 | $0 | $8 | 0.02% |
| GRAFFIUS GORDON3 | 2 BARLO CIRCLE DILLSBURG, PA 17019 | KANSAS CITY LIFE INSURANCE COMPANY | $3K | $0 | $3K | 10.28% |
| COMMONWEALTH FINANCIAL GROUP3 Filed as: COMMONWEALTH FINANCIAL | 2 BARLO CIRCLE STE C DILLSBURG, PA 17109 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $326 | $3K | 18.22% |
| UNITED BENEFIT ADVISORS LLC3 Filed as: UNITED BENEFIT ADVISORS | 280 E 96TH ST STE 250 INDIANAPOLIS, IN 46240 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $0 | $0 | 0.00% |
| COMMONWEALTH FINANCIAL GROUP3 | 2 BARLO CIRCLE, SUITE C DILLSBURG, PA 17019 | SUN LIFE INSURANCE COMPANY OF CANADA | $3K | $0 | $3K | 20.75% |
| COMMONWEALTH FINANCIAL GROUP3 Filed as: COMMONWEALTH FINANCIAL | 2 BARLO CIRCLE STE C DILLSBURG, PA 17019 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $36 | $5 | $41 | 0.98% |
| UNITED BENEFIT ADVISORS LLC3 Filed as: UNITED BENEFIT ADVISORS | 280 E 96TH ST STE 250 INDIANAPOLIS, IN 46240 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $0 | $0 | 0.00% |
| COMMONWEALTH FINANCIAL GROUP3 Filed as: COMMONWEALTH FINANCIAL | 2 BARLO CIRCLE STE C DILLSBURG, PA 17019 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $613 | $82 | $695 | 16.99% |
| UNITED BENEFIT ADVISORS LLC3 Filed as: UNITED BENEFIT ADVISORS | 280 E 96TH ST STE 250 INDIANAPOLIS, IN 43240 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $0 | $0 | 0.00% |
| COMMONWEALTH FINANCIAL GROUP3 Filed as: COMMONWEALTH FINANCIAL | 2 BARLO CIRCLE STE C DILLSBURG, PA 17019 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $655 | $61 | $716 | 23.58% |
| UNITED BENEFIT ADVISORS LLC3 Filed as: UNITED BENEFIT ADVISORS | 280 E 96TH ST STE 250 INDIANAPOLIS, IN 46240 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $0 | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMONWEALTH BENEFITS GROUP BROKER | Insurance agents and brokers Service code 22 | 2 BARLOW CIR # C DILLSBURG, PA 17019 | $28K |
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $19K |
| CAPITAL BLUE CROSS EIN 23-0455154 ADMIN | Claims processing Service code 12 | — | $6K |
| CONNECTCARE 3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $5K |
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 | 83 | 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) | 83 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 56 | $39K |
| Life insurance | KANSAS CITY LIFE INSURANCE COMPANY | 84 | $30K |
| Short-term disability | KANSAS CITY LIFE INSURANCE COMPANY | 84 | $30K |
| Long-term disability(2 contracts, 2 carriers) | KANSAS CITY LIFE INSURANCE COMPANY | 84 | $33K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 87 | $286K |
| Other(5 contracts, 3 carriers) | KANSAS CITY LIFE INSURANCE COMPANY | 84 | $67K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 87 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.