| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BUCKINGHAM INSURANCE SERVICES, INC.3 | 510 HYDE PARK DOYLESTOWN, PA 18902 | GRANULAR INSURANCE COMPANY | — | $39K | $39K | 6.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ZENITH AMERICAN SOLUTIONS EIN 52-1590516 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $219K |
| PAYER MATRIX NONE | Direct payment from the plan; Claims processing Service code 12 | 1400 N. PROV. RD., BLDG 2, STE 5000 MEDIA, PA 19063 | $214K |
| ANTHEM HEALTH PLANS, INC. EIN 06-1475928 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $183K |
| LABOR FIRST NONE | Other fees; Direct payment from the plan Service code 50 | 1000 MIDLANTIC DR SUITE 100 MT LAUREL TOWNSHIP, NJ 08054 | $73K |
| BROWN & BROWN OF CT, INC. NONE | Actuarial; Direct payment from the plan Service code 11 | 55 CAPITAL BOULEVARD, SUITE 102 ROCKY HILL, CT 06067 | $44K |
| REID & RIEGE, PC EIN 06-0867204 NONE | Legal; Direct payment from the plan Service code 29 | — | $42K |
| NOVAK FRANCELLA. LLC EIN 61-1436956 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $31K |
| DELTA DENTAL NONE | Contract Administrator; Direct payment from the plan Service code 13 | P.O. BOX 1803 ALPHARETTA, GA 30023 | $11K |
| LHV EMPLOYEE ASSISTANCE PROGRAM EIN 13-3240307 NONE | Other services; Direct payment from the plan Service code 49 | 3505 HILL BLVD. YORKTOWN HEIGHTS, NY 10598 | $8K |
| ROBERT M CHEVERIE & ASSOC PC EIN 06-1335139 NONE | Legal; Direct payment from the plan Service code 29 | 333 E RIVER DR EAST HARTFORD, CT 06108 | $6K |
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 | 324 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 142 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 466 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | AMALGAMATED LIFE | 315 | $8K |
| Stop-loss / reinsurancereinsurance | GRANULAR INSURANCE COMPANY | 320 | $648K |
| Other | AMALGAMATED LIFE | 315 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 320 | — |
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.