| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AP BENEFIT ADVISORS, LLC3 | 280 GRANITE RUN DR LANCASTER, PA 17601 | SUN LIFE ASSURANCE COMPANY OF CANADA | $69K | — | $69K | 5.16% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HIGHMARK EIN 23-1294723 MED/RX ADMIN | Claims processing; Contract Administrator Service code 12 | — | $1.5M |
| CONRAD M SIEGEL, INC. EIN 23-1669823 NONE | Actuarial Service code 11 | — | $159K |
| UNITED CONCORDIA EIN 25-1687586 DEN ADMIN | Contract Administrator; Claims processing Service code 12 | — | $153K |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 RX | Claims processing Service code 12 | — | $134K |
| CORESOURCE, INC EIN 35-1846036 COBRA | Claims processing Service code 12 | — | $51K |
| KPMG, LLP EIN 13-5565207 NONE | Accounting (including auditing) Service code 10 | — | $46K |
| AP BENEFIT ADVISORS, LLC EIN 30-0837157 BENEFIT ADMIN | Contract Administrator Service code 13 | — | $34K |
| CAREBRIDGE CORPORATION EIN 23-2614764 EAP | Contract Administrator; Claims processing Service code 12 | — | $30K |
| HIGHMARK, INC EIN 23-1294723 FSA | Claims processing; Contract Administrator Service code 12 | — | $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 | 3,430 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 41 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 88 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,559 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK, INC. | 2,864 | $206K |
| Vision | HM LIFE INSURANCE COMPANY | 2,679 | $286K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 3,430 | $1.3M |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 3,430 | $1.3M |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 3,430 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,430 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.