| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 100 MATSONFORD ROAD WAYNE, PA 19087 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $58K | — | $58K | 6.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4000 MIDLANTIC DRIVE, SUITE 300 MOUNT LAUREL, NJ 08054 | AMERICAN FIDELITY ASSURANCE COMPANY | $5K | — | $5K | 4.25% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 2300 RENAISSANCE BOULEVARD KING OF PRUSSIA, PA 19406 | AMERICAN FIDELITY ASSURANCE COMPANY | $3K | — | $3K | 2.62% |
| PENNSYLVANIA AUTO ASSOC INS AGY INC3 | UNKNOWN HARRISBURG, PA 17105 | AMERICAN FIDELITY ASSURANCE COMPANY | $2K | — | $2K | 1.83% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | PO BOX 25360 OKLAHOMA, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $1K | — | $1K | 1.31% |
| PAA SERVICES INC3 Filed as: PAA SERVICES INC. | UNKNOWN HARRISBURG, PA 17105 | AMERICAN FIDELITY ASSURANCE COMPANY | — | $597 | $597 | 0.55% |
| TRION GROUP, INC.3 Filed as: TRION GROUP INC. | 2300 RENAISSANCE BOULEVARD KING OF PRUSSIA, PA 17105 | AMERICAN FIDELITY ASSURANCE COMPANY | $160 | — | $160 | 0.15% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SVCS. | 700 WEST 47TH STREET, SUITE 1100 KANSAS CITY, MO 64112 | AMERICAN FIDELITY ASSURANCE COMPANY | $35 | — | $35 | 0.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 WEST GOLF ROAD ROLLING MEADOWS, IL 60008 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $2K | $426 | $3K | 12.01% |
| CONSOLIDATED BENEFITS INC3 Filed as: CONSOLIDATED BENEFITS INC. | 2500 ELMERTON AVENUE HARRISBURG, PA 17177 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 4.99% |
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 | 113 | 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) | 113 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CAPITAL ADVANTAGE ASSURANCE COMPANY | 134 | $974K |
| Vision | CAPITAL ADVANTAGE ASSURANCE COMPANY | 134 | $974K |
| Life insurance | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 179 | $21K |
| Short-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 97 | $108K |
| Long-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 97 | $108K |
| Prescription drug | CAPITAL ADVANTAGE ASSURANCE COMPANY | 134 | $974K |
| Other(2 contracts, 2 carriers) | AMERICAN FIDELITY ASSURANCE COMPANY | 179 | $129K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 179 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.