| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UNIVERSAL EMPLOYEE BENEFITS SOLUTIO3 Filed as: UNIVERSAL EMPLOYEE BENEFITS | 1000 DUNHAM DR SCRANTON, PA 18512 | THE GUARDIAN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 7.91% |
| UNIVERSAL EMPLOYEE BENEFITS SOLUTIO3 Filed as: UNIVERSAL EMPLOYEE BENEFITS | 1000 DUNHAM DR DUNMORE, PA 18512 | VISION BENEFITS OF AMERICA | $215 | $0 | $215 | 6.16% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE BENECON GROUP EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $20K |
| CONNECTCARE3 EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $3K |
| HIGHMARK BCBS NEPA EIN 23-2413324 ADMIN | Claims processing Service code 12 | — | $2K |
| ONEDIGITAL (PHILADELPHIA) EIN 84-3134502 BROKER | Insurance agents and brokers Service code 22 | — | -$940 |
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 | 42 | 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) | 42 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY | 42 | $29K |
| Vision | VISION BENEFITS OF AMERICA | 43 | $3K |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 41 | $144K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 43 | — |
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.