| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMWINS5 Filed as: AMWINS GROUP BENEFITS, LLC | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | TRANSAMERICA LIFE INSURANCE CO. | $42K | — | $42K | 8.48% |
| DIETRICH & ASSOCIATES3 | 1000 GERMANTOWN PIKE, SUITE K-1 PLYMOUTH MEETING, PA 19462 | TRANSAMERICA LIFE INSURANCE CO. | $29K | — | $29K | 5.90% |
| WEB TPA5 | 8500 FREEPORT PARKWAY SOUTH IRVING, TX 75063 | TRANSAMERICA LIFE INSURANCE CO. | $21K | — | $21K | 4.15% |
| AMWINS5 Filed as: AMWINS GROUP BENEFITS, LLC | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | EXPRESS SCRIPTS, INC. | $7K | — | $7K | 5.48% |
| DIETRICH & ASSOCIATES3 | 1000 GERMANTOWN PIKE, SUITE K-1 PLYMOUTH MEETING, PA 19462 | EXPRESS SCRIPTS, INC. | $4K | — | $4K | 3.28% |
| DIETRICH & ASSOCIATES3 Filed as: DIETRICH & ASSOCIATES, INC. | 1000 GERMANTOWN PIKE, SUITE K-1 PLYMOUTH MEETING, PA 19462 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 5.10% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LAURIE A. KIRICOPLES EIN 23-1502700 NONE | Contract Administrator; Trustee (directed); Trustee (individual) 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 (directed); Trustee (individual) Service code 20 | — | $30K |
| CLIFTONLARSONALLEN LLP EIN 41-0746749 NONE | Accounting (including auditing) Service code 10 | — | $28K |
| PNC BANK EIN 22-1146430 NONE | Custodial (other than securities) Service code 18 | — | $9K |
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 | 166 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 166 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | TRANSAMERICA LIFE INSURANCE CO. | 234 | $495K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 100 | $51K |
| Prescription drug | EXPRESS SCRIPTS, INC. | 214 | $127K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 234 | — |
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.