| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMERICAN INSURANCE ADMINISTRATORS3 | 4550 LENA DRIVE MECHANICSBURG, PA 17055 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $65K | — | $65K | 9.17% |
| AMERICAN INSURANCE ADMINISTRATORS3 | 4550 LENA DRIVE MECHANICSBURG, PA 17055 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $13K | — | $13K | 1.83% |
| AMERICAN INSURANCE ADMINISTRATORS3 | 4550 LENA DRIVE MECHANICSBURG, PA 17055 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $1K | — | $1K | 2.00% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | HARTFORD LIFE AND ACCIDENT | — | $455 | $455 | 17.51% |
| USI INSURANCE SERVICES LLC3 Filed as: USI/WELLS FARGO INSURANCE SERVICES | 180 PARK AVENUE STE 102 FLORHAM PARK, NJ 07932 | HARTFORD LIFE AND ACCIDENT | $390 | — | $390 | 15.01% |
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 | 840 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 10 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 853 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | CAPITAL ADVANTAGE ASSURANCE COMPANY | 740 | $72K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 802 | $713K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 802 | $713K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 802 | $713K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 738 | $1.0M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 845 | $716K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 845 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.