| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DELAWARE VALLEY HEALTH CARE3 Filed as: DELAWARE VALLEY HC COALITION | 2980 SOUTHHAMPTON ROAD PHILADELPHIA, PA 19154 | DELTA DENTAL OF PENNSYLVANIA | $1K | $0 | $1K | 0.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| D H EVANS TPA LLC DBA PATH ADMIN EIN 46-1226464 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $124K |
| BENECARD EIN 22-2998772 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $38K |
| SOUTH CENTRAL PLAN EIN 23-2664989 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $30K |
| CHARLES JOHNSTON EIN 23-2077724 NONE | Legal; Direct payment from the plan Service code 29 | — | $23K |
| DELTA DENTAL EIN 23-1667011 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $18K |
| PFM ADVISORS EIN 23-3087064 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $14K |
| WAGGONER FRUTIGER & DAUB, LLP EIN 23-1583249 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $10K |
| FOX ROTHSCHILD LLP EIN 23-1404723 NONE | Legal Service code 29 | — | $10K |
| CIGNA HEALTH AND LIFE INS COMPANY EIN 59-1031071 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $9K |
| CONRAD SIEGAL EIN 23-1669823 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $8K |
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 | 371 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 126 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 497 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF PENNSYLVANIA | 887 | $284K |
| Stop-loss / reinsurancereinsurance | STANDARD LIFE AND ACCIDENT INSURANCE CO | 412 | $327K |
| Other | NATIONAL UNION FIRE INSURANCE CO OF PITTSBURGH PA | 415 | $89K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 887 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.