| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DELAWARE VALLEY HEALTH CARE3 | 2980 SOUTHHAMPTON ROAD PHILADELPHIA, PA 19154 | DELTA DENTAL OF PENNSYLVANIA | $1K | — | $1K | — |
| 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 | — | $231K |
| SEGAL EIN 46-0619194 NONE | Consulting (general); Actuarial Service code 11 | — | $66K |
| BENECARD EIN 22-2998772 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $43K |
| PFM ADVISORS EIN 23-3087064 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $27K |
| WILLIG, WILLIAMS & DAVIDSON NONE | Legal; Direct payment from the plan Service code 29 | 1845 WALNUT ST, 24TH FLOOR PHILADELPHIA, PA 19103 | $26K |
| PACKER THOMAS EIN 34-1667340 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $18K |
| DELTA DENTAL EIN 23-1667011 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $17K |
| FOX ROTHSCHILD LLP EIN 23-1404723 NONE | Legal; Direct payment from the plan Service code 29 | — | $10K |
| WILMINGTON TRUST EIN 16-1486454 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $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 | 355 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 117 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 472 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF PENNSYLVANIA | 942 | $0 |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE CO | 370 | $362K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 942 | — |
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.