| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BUCK CONSULTANTS LLC3 Filed as: BUCK CONSULTANTS | P O BOX 202617 DALLAS, TX 75320 | METROPOLITAN LIFE INSURANCE COMPANY | — | $930 | $930 | 1.88% |
| BUCK CONSULTANTS LLC3 Filed as: BUCK CONSULTANTS | P O BOX 202617 DALLAS, TX 75320 | METROPOLITAN LIFE INSURANCE COMPANY | — | $70 | $70 | 0.14% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MEDICAL MUTUAL SERVICES EIN 34-1922587 N/A | Claims processing Service code 12 | — | $501K |
| CENTRAL DATA SERVICES EIN 25-1352803 N/A | Contract Administrator Service code 13 | — | $129K |
| THE SEGAL COMPANY EIN 13-1975125 N/A | Actuarial Service code 11 | 333 WEST 34TH STREET NEW YORK, NY 100012402 | $65K |
| MACALA, GORE & PIATT, LLC EIN 34-1314889 N/A | Insurance agents and brokers Service code 22 | — | $44K |
| ANNESS, GERLACH & WILLIAMS, CPAS EIN 34-1451668 N/A | Accounting (including auditing) Service code 10 | — | $31K |
| SEGALL, BRYANT & HAMILL EIN 41-1788385 N/A | Investment advisory (plan) Service code 27 | 10 SOUTH WACKER DRIVE STE 3500 CHICAGO, IL 60606 | $27K |
| ANDCO CONSULTING, LLC EIN 59-3676225 N/A | Investment advisory (plan) Service code 27 | 4901 VINELAND ROAD, SUITE 600 ORLANDO, FL 32811 | $22K |
| KEYBANK N/A | Trustee (bank, trust company, or similar financial institution) Service code 21 | 127 PUBLIC SQUARE CLEVELAND, OH 44114 | $18K |
| LIBERTY INSURANCE AGENCY N/A | Insurance agents and brokers Service code 22 | 1910 COCHRAN ROAD, SUITE 800 PITTSBURGH, PA 15220 | $9K |
| WEX HEALTH EIN 06-1593514 N/A | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 82 HOPMEADOW STREET STE 220 SIMSBURY, CT 06089 | $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 | 1,055 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 322 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,377 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,377 | $49K |
| Other(2 contracts, 2 carriers) | NATIONWIDE LIFE INSURANCE COMPANY | 1,377 | $746K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,377 | — |
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.