| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INSURANCE COALITION3 Filed as: INSURANCE COALITION INC. | 417 WALNUT ST HARRISBURG, PA 17101 | DELTA DENTAL OF PENNSYLVANIA | $5K | $0 | $5K | 9.98% |
| USI INSURANCE SERVICES LLC3 | 200 SUMMIT LAKE DRIVE SUITE 350 VALHALLA, NY 10595 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $2K | $3K | 12.70% |
| PCI INSURANCE AGENCY3 Filed as: PCI INSURANCE INC. | 417 WALNUT ST HARRISBURG, PA 17110 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 7.41% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | EYEMED VISION | $1K | $0 | $1K | 9.75% |
| INSURANCE COALITION3 Filed as: INSURANCE COALITION INC. | 417 WALNUT ST HARRISBURG, PA 17101 | EYEMED VISION | $187 | $0 | $187 | 1.63% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX AGENCY INC. | PO BOX 948 HENRIETTA, NY 14467 | COMPANION LIFE INSURANCE COMPANY | $250 | $0 | $250 | 14.98% |
| CONSOLIDATED BENEFITS INC3 Filed as: CONSOLIDATED BENEFITS INC. | 2500 ELMERTON AVE HARRISBURG, PA 17110 | COMPANION LIFE INSURANCE COMPANY | $125 | $0 | $125 | 7.49% |
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 | 120 | 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) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF PENNSYLVANIA | 104 | $49K |
| Vision | EYEMED VISION | 164 | $11K |
| Life insurance | COMPANION LIFE INSURANCE COMPANY | 116 | $2K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 114 | $26K |
| Other | COMPANION LIFE INSURANCE COMPANY | 116 | $2K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 164 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.