| 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. | $99K | $7K | $106K | 3.47% |
| PENTRA LLC3 Filed as: PENTRA, INC. | TWO VILLANOVA CENTER VILLANOVA, PA 19085 | DELTA DENTAL OF CT, INC. | $15K | — | $15K | 5.00% |
| PENTRA LLC3 Filed as: PENTRA, INC. | 795 E LANCASTER AVENUE, SUITE 210 VILLANOVA, PA 190851525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $16K | $3K | $19K | 18.26% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 2.68% |
| PENTRA LLC3 Filed as: PENTRA, INC. | 795 E LANCASTER AVENUE, SUITE 210 VILLANOVA, PA 190851525 | ORRIANT LLC | $1K | — | $1K | 3.31% |
| PENTRA LLC3 Filed as: PENTRA, INC. | 795 E LANCASTER AVENUE, SUITE 210 VILLANOVA, PA 190851525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 8.45% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $918 | $918 | 2.97% |
| PENTRA LLC3 Filed as: PENTRA, INC. | 795 E LANCASTER AVENUE, SUITE 210 VILLANOVA, PA 190851525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $4K | 14.35% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $922 | $922 | 3.73% |
| PENTRA LLC3 Filed as: PENTRA, INC. | 795 E LANCASTER AVENUE, SUITE 210 VILLANOVA, PA 190851525 | VISION SERVICE PLAN | $1K | — | $1K | 5.14% |
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 | 313 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 313 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CONNECTICARE, INC. | 452 | $3.0M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF CT, INC. | 551 | $299K |
| Vision | VISION SERVICE PLAN | 247 | $24K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 313 | $137K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 275 | $0 |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 275 | $25K |
| Prescription drug | CONNECTICARE, INC. | 452 | $3.0M |
| Other(4 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 313 | $192K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 551 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.