| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GORDON W ST JOHN3 Filed as: GORDON ST. JOHN | 453 GLENWYTH ROAD STAFFORD, PA 19087 | CONNECTICARE, INC. | $89K | $4K | $93K | 3.40% |
| PENTRA LLC3 Filed as: PENTRA, INC. | 795 E LANCASTER AVENUE, SUITE 210 VILLANOVA, PA 19085 | DELTA DENTAL INSURANCE COMPANY | $17K | — | $17K | 5.50% |
| PENTRA LLC3 Filed as: PENTRA, INC. | 795 E LANCASTER AVENUE, SUITE 210 VILLANOVA, PA 19085 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $14K | $2K | $16K | 16.82% |
| PENTRA LLC3 Filed as: PENTRA, INC. | 795 E LANCASTER AVENUE, SUITE 210 VILLANOVA, PA 19085 | ORRIANT LLC | $1K | — | $1K | 2.99% |
| PENTRA LLC3 Filed as: PENTRA, INC. | 795 E LANCASTER AVENUE, SUITE 210 VILLANOVA, PA 190851525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $521 | $4K | 11.70% |
| UNITED OF OMAHA LIFE INSURANCE CO3 Filed as: UNITED OF OMAHA LIFE INSURANCE CO. | — | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $8K | $8K | 24.99% |
| PENTRA LLC3 Filed as: PENTRA, INC. | 795 E LANCASTER AVENUE, SUITE 210 VILLANOVA, PA 190851525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $495 | $2K | 6.62% |
| PENTRA LLC3 Filed as: PENTRA, INC. | 795 E LANCASTER AVENUE, SUITE 210 VILLANOVA, PA 190851525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $137 | $137 | 0.45% |
| PENTRA LLC3 Filed as: PENTRA, INC. | 795 E LANCASTER AVENUE, SUITE 210 VILLANOVA, PA 190851525 | VISION SERVICE PLAN | $1K | — | $1K | 5.17% |
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 | 281 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 281 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CONNECTICARE, INC. | 444 | $2.7M |
| Dental | DELTA DENTAL INSURANCE COMPANY | 262 | $301K |
| Vision | VISION SERVICE PLAN | 244 | $23K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 281 | $125K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 244 | $31K |
| Prescription drug | CONNECTICARE, INC. | 444 | $2.7M |
| Other(4 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 281 | $174K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 444 | — |
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.