| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROC CONSULTING GROUP3 Filed as: ROC CONSULTING GROUP, INC | 2297 DORCHESTER STREET WEST FURLONG, PA 18925 | AMALGAMATED LIFE | $1K | — | $1K | 3.20% |
| VAN HORN INSURANCE AGENCY | PO BOX 508 MONTGOMERYVILLE, PA 18936 | OHIO CASUALTY INSURANCE COMPANY | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| INDEPENDENCE BLUE CROSS CLAIMS ADMINISTRATOR | Claims processing Service code 12 | 1901 MARKET STREET PHILADELPHIA, PA 19103 | $675K |
| BRICKLAYERS BENEFIT PLANS, INC EIN 23-1739024 THIRD PARTY ADMINISTRATOR | Plan Administrator Service code 14 | 1300 VIRGINIA DR STE 101 FORT WASHINGTON, PA 19034 | $354K |
| O'DONOGHUE & O'DONOGHUE, LLP EIN 53-0120528 ATTORNEY | Accounting (including auditing) Service code 10 | 325 CHESTNUT ST., STE 515 PHILADELPHIA, PA 19106 | $197K |
| NOVAK FRANCELLA, LLC CPA'S EIN 61-1436956 COMPLIANCE EXAMINATIONS | Accounting (including auditing) Service code 10 | ONE PRESIDENTIAL BLVD. BALA CYNWYD, PA 19004 | $96K |
| DELTA DENTAL CLAIMS ADMINISTRATOR | Claims processing Service code 12 | ONE DELTA DRIVE MECHANICSBURG, PA 170556999 | $49K |
| EXPRESS SCRIPTS, INC EIN 43-1420563 CLAIMS ADMINISTRATOR | Claims processing Service code 12 | — | $41K |
| KEVIN J. MIRARCHI, CPA EIN 23-2809700 ACCOUNTANT | Accounting (including auditing) Service code 10 | 77 W. BALTIMORE PIKE MEDIA, PA 19063 | $39K |
| THE MCKEOGH COMPANY ACTUARY | Actuarial Service code 11 | 200 BARR HARBOR DRIVE WEST CONSHOHOCKEN, PA 19428 | $25K |
| THOMAS MCGOLDRICK, ESQ. ATTORNEY | Legal Service code 29 | 10 E.6TH AVENUE SUITE 100 CONSHOHOCKEN, PA 19428 | $23K |
| HAGGERTY & HAGGERTY, P.A., CPA'S EIN 51-0255384 AUDITOR | Accounting (including auditing) Service code 10 | 510 PHILADELPHIA PIKE WILMINGTON, DE 19809 | $13K |
| INNOVATIVE SOFTWARE SOLUTIONS, INC. IT SOFTWARE MGMT | Other services Service code 49 | TWO EXECUTIVE CAMPUS 400 CHERRY HILL, NJ 08002 | $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 | 1,142 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,142 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | AMALGAMATED LIFE | 1,142 | $39K |
| Stop-loss / reinsurancereinsurance | HM INSURANCE GROUP | 917 | $603K |
| Other | OHIO CASUALTY INSURANCE COMPANY | 0 | $582 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,142 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.