| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CUMMINGS FRASER & ASSOCIATES, LLC3 Filed as: CUMMINGS INSURANCE AGENCY INC. | 1301 MADISON AVE DUNMORE, PA 18503 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $1K | $4K | 12.91% |
| INDEPENDENCE PLANNING GROUP3 | 1767 SENTRY PARKWAY WEST, SUITE 200 BLUE BELL, PA 19422 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $16 | $0 | $16 | 0.05% |
| MAZZMAR LLC3 | 1767 SENTRY PARKWAY W STE 200 BLUE BELL, PA 19422 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $9 | $0 | $9 | 0.03% |
| KEYSTONE INSURANCE & BENEFITS GROUP3 Filed as: KEYSTONE INS. & BENEFITS GRP LLC | 1995 POINT TOWNSHIP DR NORTHUMBERLAND, PA 17857 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $492 | $2K | 27.76% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CUMMINGS INSURANCE AGENCY EIN 23-2732076 BROKER | Insurance agents and brokers Service code 22 | — | $14K |
| THE BENECON GROUP LLC EIN 23-1315351 BROKER | Insurance agents and brokers Service code 22 | — | $12K |
| CONNECTCARE3 LLC EIN 26-1768616 PATIENT ADVOCATE | Other services Service code 49 | — | $3K |
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 | 39 | 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) | 39 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 39 | $30K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 39 | $30K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 56 | $6K |
| Stop-loss / reinsurancereinsurance | EVEREST REINSURANCE COMPANY | 39 | $153K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 56 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 56 | — |
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.