| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HENDERSON BROTHERS, INC.3 | 920 FORT DUQUESNE BLVD. PITTSBURGH, PA 15222 | UPMC HEALTH OPTIONS | $29K | — | $29K | 2.69% |
| HENDERSON BROTHERS, INC.3 | 920 FORT DUQUESNE BLVD. PITTSBURGH, PA 15222 | PRINCIPAL LIFE INSURANCE COMPANY | $9K | — | $9K | 6.65% |
| HENDERSON BROTHERS, INC.3 | 920 FORT DUQUESNE BLVD. PITTSBURGH, PA 15222 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $13 | $3K | 12.03% |
| HENDERSON BROTHERS, INC.3 | 920 FORT DUQUESNE BLVD. PITTSBURGH, PA 15222 | VISION SERVICE PLAN | $767 | — | $767 | 7.32% |
| ASSUREX3 Filed as: ASSUREX GLOBAL CORP | 175 S 3RD STREET SUITE 800 COLUMBUS, OH 43215 | VISION SERVICE PLAN | $262 | — | $262 | 2.50% |
| PETER J MACE3 Filed as: PETER J. MACE | 5775 D GLENRIDGE DRIVE SUITE 350 ATLANTA, GA 30328 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $367 | — | $367 | 3.51% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SVCS USA | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $157 | — | $157 | 1.50% |
| HENDERSON BROTHERS, INC.3 | 920 FORT DUQUESNE BLVD. PITTSBURGH, PA 15222 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 13.64% |
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 | 169 | 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) | 169 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UPMC HEALTH OPTIONS | 234 | $1.1M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 289 | $129K |
| Vision | VISION SERVICE PLAN | 122 | $10K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 289 | $139K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 289 | $129K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 171 | $25K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 55 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 289 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.