| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TIMBERLINE HEALTHCARE CONSULTING3 | 112 ELLSWORTH DRIVE SINKING SPRING, PA 19608 | TRANSAMERICA LIFE | $12K | — | $12K | 3.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PATH ADMINISTRATORS, INC. EIN 46-1226464 NONE | Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | — | $407K |
| CIGNA EIN 59-1031071 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $135K |
| BENECARD, INC. EIN 22-2998772 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $93K |
| CHARLES JOHNSTON EIN 23-2077724 NONE | Legal; Direct payment from the plan Service code 29 | — | $65K |
| NOVAK FRANCELLA, LLC EIN 61-1436956 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $54K |
| DELTA DENTAL EIN 23-1667011 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $35K |
| SOUTH CENTRAL PREFERRED EIN 23-2664989 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $30K |
| BROWN, SCHULTZ, SHERIDAN, & FRITZ EIN 25-1644159 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $29K |
| PFM ASSET MANAGEMENT, LLC EIN 23-3087064 NONE | Investment advisory (plan); Investment management fees paid directly by plan Service code 27 | — | $29K |
| THE SAVITZ ORGANIZATION EIN 23-1700844 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $29K |
| INETICO INC EIN 20-0457663 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $20K |
| JACOBY DONNER, P.C. EIN 23-2220388 NONE | Legal; Direct payment from the plan Service code 29 | — | $19K |
| BUCKINGHAM INSURANCE NONE | Insurance services; Direct payment from the plan Service code 23 | 350 S. MAIN STREET - 117B DOYLESTOWN, PA 18901 | $9K |
| US BANK EIN 31-0841368 NONE | Direct payment from the plan; Soft dollars commissions; Custodial (securities); Float revenue Service code 19 | — | $6K |
| NATIONAL VISION ADMINISTRATORS EIN 74-3033381 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $5K |
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 | 898 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 561 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,459 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | TRANSAMERICA LIFE | 1,025 | $407K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,025 | — |
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.