| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 Filed as: THE SEGAL COMPANY OF EASTERN STATES | 333 W 34TH ST NEW YORK, NY 10001 | SUN LIFE ASSURANCE COMPANY OF CANADA | $46K | — | $46K | 5.45% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES CENTRAL INC | 75 REMITTANCE DR DEPT 1926 CHICAGO, IL 60675 | HARTFORD LIFE AND ACCIDENT | — | $1K | $1K | 0.47% |
| AON CONSULTING INC3 | 555 EAST LANCASTER AVE STE 300 RADNOR, PA 19087 | HARTFORD LIFE AND ACCIDENT | — | $56 | $56 | 0.37% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| KEYSTONE HEALTH PLAN EAST EIN 23-2314460 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $1.7M |
| LOCAL 36 BOLR PENSION PLAN EIN 23-6546776 RELATED FUND | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $216K |
| DENISE KITZINGER EIN 23-2105239 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $150K |
| JOHN J RONGIONE EIN 23-2105239 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $106K |
| BLUEWATER CONSULTING GROUP NONE | Consulting (general); Direct payment from the plan Service code 16 | 1100 E. HECTOR ST. SUITE 315 CONSHOHOCKEN, PA 19428 | $103K |
| THE SEGAL COMPANY EIN 06-0839113 NONE | Actuarial; Other commissions; Direct payment from the plan Service code 11 | — | $96K |
| LINDA MCCULLOUGH EIN 23-2105239 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $93K |
| JUDY O'MEARA EIN 23-2105239 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $86K |
| MARIA GRILLO EIN 23-2105239 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $79K |
| STEVENS & LEE PC EIN 23-1886296 NONE | Legal; Direct payment from the plan Service code 29 | — | $79K |
| CHRISTINA KOBRYN EIN 23-2105239 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $77K |
| CYNTHIA LEAHY EIN 23-2105239 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $72K |
| DELTA DENTAL EIN 23-1667011 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $70K |
| TYEMA SANCHEZ EIN 23-2105239 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $68K |
| VERONICA MOORE EIN 23-2105239 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $65K |
| SONIA RODRIQUEZ EIN 23-2105239 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $62K |
| DONNA HESTON EIN 23-2105239 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $61K |
| MADELYN VELEZ EIN 23-2105239 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $57K |
| CARMEN MCCARTHY EIN 23-2105239 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $55K |
| BASYS SYSTEMS EIN 52-1796473 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general) Service code 15 | — | $55K |
| SPEAR WILDERMAN P.C. EIN 23-2749511 NONE | Legal; Direct payment from the plan Service code 29 | — | $53K |
| ERICA HARRELL EIN 23-2105239 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $53K |
| JAMIE POLICHETTI EIN 23-2105239 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $50K |
| JOANNA OLEJNICZAK EIN 23-2105239 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $44K |
| AMERIHEALTH PA HMO EIN 23-2314460 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $36K |
| NOVAK FRANCELLA LLC EIN 61-1436956 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $23K |
| DE VALLEY HEALTH CARE COALITION EIN 23-2813763 NONE | Other services; Insurance agents and brokers; Other commissions Service code 22 | — | $19K |
| NATIONAL VISION ADMINISTRATORS LLC EIN 74-3033381 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $19K |
| EXPRESS SCRIPTS EIN 43-1420563 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $14K |
| CROSS CURRENT CORPORATION EIN 23-2779645 NONE | Direct payment from the plan; Consulting (general); Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $12K |
| PFM ASSET MANAGEMENT, LLC. EIN 23-1992164 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $10K |
| SMITH GRAHAM & CO INVESMENT ADV. EIN 76-0301817 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $7K |
| SILK CLINIC PC EIN 23-1708258 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $6K |
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 | 3,447 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,459 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | HARTFORD LIFE AND ACCIDENT | 3,353 | $245K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 10,167 | $844K |
| Other | HARTFORD LIFE AND ACCIDENT | 3,353 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 10,167 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.