| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PROGRESSIVE PLAN ADMINISTRATORS3 | 470 PARK AVENUE SOUTH NEW YORK, NY 10016 | EMBLEMHEALTH | $30K | — | $30K | 4.19% |
| NATIONAL GROUP PROTECTION INC3 | 1445 GREENBRIER PLACE CHARLOTTESVILLE, VA 22901 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 6.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENSERCO, INC. EIN 13-2732561 SERVICES RELATED PLAN | Contract Administrator Service code 13 | — | $1.0M |
| BENEFIT SERVICES OF PA EIN 52-1511210 SERVICES RELATED PLAN | Claims processing Service code 12 | — | $431K |
| EMPIRE HEALTHCHOICE ASSURANCE, INC. EIN 23-7391136 NONE | Other services; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator Service code 12 | — | $425K |
| STACEY BRAUN ASSOCIATES, INC. EIN 13-2889432 NONE | Soft dollars commissions; Investment management fees paid directly by plan Service code 51 | — | $99K |
| THE SEGAL COMPANY EIN 13-1835864 NONE | Actuarial; Consulting (general) Service code 11 | — | $54K |
| MED REVIEW, INC. EIN 13-3240352 NONE | Claims processing Service code 12 | — | $52K |
| BUCHBINDER TUNICK & COMPANY LLP EIN 13-1578842 SERVICES RELATED PLAN | Accounting (including auditing) Service code 10 | — | $47K |
| KLEIN ZELMAN ROTHERMEL JACOBS SCHES EIN 13-2998136 SERVICES RELATED PLAN | Legal Service code 29 | — | $45K |
| AMALGAMATED BANK EIN 13-4920330 SERVICES RELATED PLAN | Custodial (securities) Service code 19 | — | $24K |
| SEGAL ADVISORS, INC. EIN 13-2646110 NONE | Investment management fees paid directly by plan Service code 51 | — | $15K |
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 | 1,479 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,479 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMBLEMHEALTH | 102 | $723K |
| Dental(2 contracts, 2 carriers) | UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY | 324 | $120K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 854 | $51K |
| Stop-loss / reinsurancereinsurance | STANDARD SECURITY LIFE INSURANCE COMPANY | 1,445 | $1.3M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 854 | $51K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,445 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.