| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVID M. BANET & ASSOCIATES3 Filed as: DAVID M. BANET | 45 DOWLIN FORGE ROAD EXTON, PA 193411548 | KAISER FOUNDATION HEALTH PLAN INC. | $9K | — | $9K | 3.83% |
| DAVID M. BANET & ASSOCIATES3 Filed as: DAVID M. BANET & ASSOCIATES INC. | 45 DOWLIN FORGE ROAD EXTON, PA 19341 | UNITY HEALTH PLANS INSURANCE CORPORATION | $5K | — | $5K | 2.85% |
| DAVID M. BANET & ASSOCIATES3 Filed as: DAVID BANET | 45 DOWLIN FORGE ROAD EXTON, PA 19341 | CAPITAL DISTRICT PHYSICIANS HEALTH PLAN, INC. | $5K | — | $5K | 3.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVENUE HARTFORD, CT 06156 | $663K |
| UNUM LIFE INSURANCE COMPANY OF EIN 01-0278678 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | AMERICA ONE FOUNTAIN SQUARE 3 WEST CHATTANOOGA, TN 37402 | $33K |
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 | 1,055 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 19 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,074 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CAPITAL DISTRICT PHYSICIANS HEALTH PLAN, INC. | 22 | $153K |
| Dental | AETNA LIFE INSURANCE COMPANY | 1 | $4K |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 915 | $105K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,866 | $608K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 11 | $6K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,866 | $608K |
| Prescription drug(3 contracts, 3 carriers) | CAPITAL HEALTH PLAN | 93 | $852K |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,866 | $636K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,866 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.