| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UNIVEST INSURANCE INC3 | 521 W MAIN ST LANSDALE, PA 17437 | UNITEDHEALTHCARE INSURANCE COMPANY | $4K | $0 | $4K | 5.48% |
| UNIVEST INSURANCE INC3 | 1473 DUNWOOD DR WEST CHESTER, PA 19380 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 9.94% |
| BENEFITMALL3 Filed as: BENEFITMALL, INC | 501 FAIRMOUNT AVE TOWSON, MD 21286 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $925 | $925 | 2.99% |
| UNIVEST INSURANCE INC3 | 1473 DUNWOOD DR WEST CHESTER, PA 19380 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $0 | $4K | 14.99% |
| BENEFITMALL3 Filed as: BENEFITMALL, INC | 501 FAIRMOUNT AVE TOWSON, MD 21286 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $724 | $724 | 3.01% |
| UNIVEST INSURANCE INC3 | 1473 DUNWOOD DR WEST CHESTER, PA 19380 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 14.65% |
| BENEFITMALL3 Filed as: BENEFITMALL, INC | 501 FAIRMOUNT AVE TOWSON, MD 21286 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $531 | $531 | 3.02% |
| UNIVEST INSURANCE INC3 | 1473 DUNWOOD DR WEST CHESTER, PA 19380 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 10.00% |
| BENEFITMALL3 Filed as: BENEFITMALL, INC | 501 FAIRMOUNT AVE TOWSON, MD 21286 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $452 | $452 | 3.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNIVEST INSURANCE, INC EIN 23-3021746 BROKER | Insurance agents and brokers Service code 22 | — | $35K |
| THE BENECON GROUP, LLC EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $21K |
| UMR EIN 39-1995276 ADMIN | Claims processing Service code 12 | — | $7K |
| CONNECTCARE 3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $7K |
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 | 274 | 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) | 274 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 223 | $79K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 223 | $79K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 274 | $39K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 42 | $18K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | EVEREST REINSURANCE COMPANY | 114 | $272K |
| Other(5 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 274 | $88K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 274 | — |
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.