| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TRION GROUP, INC.3 | 2300 RENAISSANCE BLVD. KING OF PRUSSIA, PA 19406 | AETNA LIFE INSURANCE COMPANY | — | $296 | $296 | 1.91% |
| TRION GROUP, INC.3 | 2300 RENAISSANCE BLVD. KING OF PRUSSIA, PA 19406 | AETNA LIFE INSURANCE COMPANY | — | $211 | $211 | 1.91% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| KPMG LLP EIN 13-5565207 PLAN AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $97K |
| CORESOURCE, INC. EIN 35-1846036 THIRD-PARTY ADMINISTRATO | Participant communication; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Recordkeeping fees; Other services; Direct payment from the plan Service code 12 | — | $39K |
| THE NORTHERN TRUST COMPANY EIN 36-1561860 TRUSTEE, INV. MGMT & ADV | Investment advisory (plan); Direct payment from the plan; Trustee (bank, trust company, or similar financial institution); Soft dollars commissions; Investment management fees paid directly by plan; Investment management; Other investment fees and expenses; Trustee (directed); Account maintenance fees Service code 21 | — | $39K |
| BLUE CROSS BLUE SHIELD OF ALABAMA EIN 63-0103830 THIRD-PARTY ADMINISTRATO | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Recordkeeping fees; Direct payment from the plan; Participant communication Service code 12 | — | $25K |
| WILLIS TOWERS WATSON EIN 26-0775680 HRA ADMIN AND RX COLLABO | Other services; Other fees; Direct payment from the plan Service code 49 | — | $24K |
| ERNST & YOUNG LLP EIN 34-6565596 TAX FORM PREPARER | Consulting (general); Direct payment from the plan Service code 16 | — | $23K |
| FIDELITY INV INST OP CO, INC. EIN 04-2647786 RECORDKEEPER | Participant communication; Recordkeeping fees; Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $22K |
| ACTIVEHEALTH MANAGEMENT, INC. EIN 52-2182411 WELLNESS,DISEASE,ETC MGM | Direct payment from the plan; Other services; Other fees Service code 49 | — | $19K |
| CROWE LLP EIN 35-0921680 FINANCIAL STATEMENT PREP | Direct payment from the plan; Consulting (general); Accounting (including auditing) Service code 10 | — | $18K |
| PRIME THERAPEUTICS LLC EIN 26-0076803 PHARMACY BENEFIT MANAGER | Recordkeeping fees; Direct payment from the plan; Contract Administrator; Claims processing; Float revenue; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Participant communication Service code 12 | — | $11K |
| EXPRESS SCRIPTS, INC. EIN 22-3461740 PHARMACY BENEFIT MANAGER | Recordkeeping fees; Direct payment from the plan; Contract Administrator; Claims processing; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Participant communication Service code 12 | — | $7K |
| STANDISH MELLON ASSET MGMT CO, LLC EIN 25-1890416 INVESTMENT MANAGER | Direct payment from the plan; Investment management; Investment management fees paid directly by plan Service code 28 | — | $6K |
| NORTHERN TRUST CORPORATION EIN 36-2723087 TRUSTEE | Investment management fees paid indirectly by plan; Soft dollars commissions; Other services Service code 49 | — | $0 |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 633 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 633 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts) | AETNA LIFE INSURANCE COMPANY | 127 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 127 | — |
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."
No prospect flags tripped on this filing.