No insurance carriers on this filing. Self-funded welfare plans typically pay TPAs and PBMs through Schedule C, not Schedule A.
No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MAIN LINE FAMILY DENTISTRY EIN 23-2743955 PROVIDER | Employee (plan) Service code 30 | 931 HAVERFORD ROAD BRYN MAWR, PA 19010 | $119K |
| BRYN MAWR DENTAL ASSOCIATES EIN 23-3023759 PROVIDER | Employee (plan) Service code 30 | 945 HAVERFORD ROAD, 2ND FLOOR BRYN MAWR, PA 19010 | $113K |
| GEOFFREY E. DONOHO, DDS EIN 86-1174776 PROVIDER | Employee (plan) Service code 30 | 54 RITTENHOUSE PLACE ARDMORE, PA 19003 | $47K |
| BRYN MAWR DENTAL HEALTH GROUP EIN 23-1966639 PROVIDER | Employee (plan) Service code 30 | 19 MORRIS AVENUE BRYN MAWR, PA 19010 | $43K |
| ROBIN D. HARSHAW, DMD & ASSOCIATES EIN 23-2635775 PROVIDER | Employee (plan) Service code 30 | 780 LANCASTER AVENUE, SUITE 1000 BRYN MAWR, PA 19010 | $31K |
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 | 394 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 397 | Active + retired/separated + beneficiaries. No dependents. |
No Schedule A insurance contracts on this filing — typical of fully self-funded plans, where the only headcount is the Form 5500 number above.
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."
Self-funded plan with no stop-loss carrier attached. Catastrophic-risk exposure; stop-loss specialist sales target.