| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DELAWARE VALLEY HEALTH CARE | — | DELTA DENTAL OF PENNSYLVANIA | $527 | — | $527 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 NONE | Contract Administrator Service code 13 | 151 FARMINGTON AVE HARTFORD, CT 06156 | $106K |
| SEGAL CONSULTING NONE | Direct payment from the plan; Actuarial Service code 11 | 500 OFFICE CENTER DRIVE FORT WASHINGTON, PA 19034 | $69K |
| IE SHAFFER NONE | Contract Administrator; Direct payment from the plan Service code 13 | 830 BEAR TAVERN ROAD WEST TRENTON, NJ 08628 | $50K |
| MEYER UNKOVIC & SCOTT LLP NONE | Legal; Direct payment from the plan Service code 29 | 535 SMITHFIELD ST. STE 1300 PITTSBURGH, PA 15222 | $46K |
| CALIBRE CPA GROUP, PLLC NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | 7501 WISCONSION AVE BETHESDA, MD 20814 | $34K |
| ANDCO CONSULTING EIN 59-3676225 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | 531 WEST MORSE BLVD WINTER PARK, FL 32789 | $25K |
| KANG HAGGERTY & FETBROYT LLC NONE | Legal; Direct payment from the plan Service code 29 | 123 S BROAD ST. STE 1670 PHILIADELPHIA, PA 19109 | $20K |
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 | 304 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 304 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF PENNSYLVANIA | 601 | $0 |
| Vision | VISION BENEFITS OF AMERICA | 255 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 601 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.