| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: AP BENEFIT ADVISORS, LLC DBA EONE | 7556 TEAGUE RD #300 HANOVER, MD 21076 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $33K | $10K | $42K | 25.90% |
| AP BENEFIT ADVISORS, LLC3 | 7556 TEAGUE RD #300 HANOVER, MD 21076 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | $2K | $9K | 8.44% |
| AP BENEFIT ADVISORS, LLC3 | 10 N PARK DR STE 200 HUNT VALLEY, MD 21030 | VISION SERVICE PLAN | $921 | — | $921 | 6.22% |
| VILIAM CHOMA4 | 1743 CREEK VIEW DR FOGELSVILLE, PA 18051 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $307 | — | $307 | 4.55% |
| KEYSTONE COMMERCE GROUP LLC4 | 3916 GREEN ST HARRISBURG, PA 17110 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $268 | — | $268 | 3.97% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LUMINARE HEALTH BENEFITS, INC. EIN 35-1846036 MEDICAL/RX ADMIN FEES | Claims processing; Plan Administrator; Other services Service code 12 | — | $108K |
| AP BENEFIT ADVISORS, LLC EIN 45-2712335 BROKER | Insurance agents and brokers; Consulting (general) Service code 16 | — | $83K |
| CIGNA PPO EIN 59-1031071 MEDICAL/RX ADMIN FEES | Claims processing; Other services Service code 12 | — | $30K |
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 | 180 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 184 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 142 | $105K |
| Vision | VISION SERVICE PLAN | 98 | $15K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 180 | $163K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 180 | $163K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 180 | $163K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 180 | $170K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 180 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.