| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMWINS5 | 50 WHITECAP DRIVE NORTH KINGSTON, RI 02852 | TRANSAMERICA LIFE INSURANCE CO. (MEDICARE SUPPLEMENT) | $65K | — | $65K | 8.42% |
| DIETRICH & ASSOCIATES5 | 1000 GERMANTOWN PIKE, SUITE K-1 PLYMOUTH MEETING, PA 19462 | TRANSAMERICA LIFE INSURANCE CO. (MEDICARE SUPPLEMENT) | $45K | — | $45K | 5.87% |
| WEB TPA5 | 8500 FREEPORT PKWAY ST IRVING, TX 75063 | TRANSAMERICA LIFE INSURANCE CO. (MEDICARE SUPPLEMENT) | $23K | — | $23K | 3.04% |
| AMWINS5 | 50 WHITECAP DRIVE NORTH KINGSTON, RI 02852 | EXPRESS SCRIPTS INC (PRESCRIPTION DRUG) | $11K | — | $11K | 5.52% |
| DIETRICH & ASSOCIATES3 | 1000 GERMANTOWN PIKE, SUITE K-1 PLYMOUTH MEETING, PA 19462 | EXPRESS SCRIPTS INC (PRESCRIPTION DRUG) | $6K | — | $6K | 3.30% |
| DIETRICH & ASSOCIATES3 | 1000 GERMANTOWN PIKE, SUITE K-1 PLYMOUTH MEETING, PA 19462 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 5.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LAURIE KIRICOPLES EIN 23-1502700 NONE | Trustee (individual); Contract Administrator; Trustee (directed) Service code 13 | — | $32K |
| THOMAS FORD EIN 23-1502700 NONE | Trustee (directed); Trustee (individual) Service code 20 | — | $32K |
| ROBERT GOWDY EIN 23-1502700 NONE | Trustee (individual); Trustee (directed) Service code 20 | — | $30K |
| WALTER & SHUFFAIN, PC EIN 04-3236498 NONE | Accounting (including auditing) Service code 10 | — | $23K |
| HEALTH EQUITY (F/K/A WAGEWORKS) EIN 94-3351864 NONE | Contract Administrator; Claims processing Service code 12 | — | $15K |
| PNC BANK EIN 25-1211909 NONE | Custodial (other than securities) Service code 18 | — | $10K |
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 | 521 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 521 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | TRANSAMERICA LIFE INSURANCE CO. (MEDICARE SUPPLEMENT) | 353 | $766K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 129 | $66K |
| Prescription drug | EXPRESS SCRIPTS INC (PRESCRIPTION DRUG) | 319 | $191K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 353 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.