| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXPRESS SCRIPTS, INC. EIN 22-3461740 NONE | Contract Administrator; Claims processing Service code 12 | — | $993K |
| THE SEGAL COMPANY EIN 13-1835864 NONE | Consulting (general); Actuarial Service code 11 | — | $106K |
| CALIBRE CPA GROUP, PLLC EIN 47-0900880 NONE | Accounting (including auditing) Service code 10 | — | $48K |
| SEGAL MARCO ADVISORS EIN 13-2646110 NONE | Investment advisory (plan) Service code 27 | — | $33K |
| SAVEON SP EIN 47-3603390 NONE | Contract Administrator Service code 13 | — | $32K |
| AMERICAN HEALTH HOLDINGS, INC. EIN 31-1368946 NONE | Other fees Service code 99 | — | $23K |
| O'DONOGHUE & O'DONOGHUE LLP EIN 53-0120528 NONE | Legal Service code 29 | — | $22K |
| BASYS EIN 52-1796473 NONE | Other fees Service code 99 | — | $21K |
| US REAL ESTATE INVESTMENT FUND EIN 11-3786306 NONE | Investment management fees paid directly by plan Service code 51 | — | $18K |
| INVESTMENT PERFORMANCE SERVICES LLC EIN 58-2432390 NONE | Investment advisory (plan) Service code 27 | — | $18K |
| LIVONGO NONE | Other fees Service code 99 | 2 MANHATTANVILLE RD PURCHASE, NY 10577 | $15K |
| COMERICA BANK EIN 42-1741646 NONE | Other investment fees and expenses; Custodial (securities); Float revenue Service code 19 | 411 W. LAFAYETTE AVE DETROIT, MI 48226 | $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 | 641 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 24 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 665 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 685 | $41K |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 665 | $10K |
| Stop-loss / reinsurancereinsurance | ULLICO | 665 | $557K |
| Other | AETNA LIFE INSURANCE COMPANY | 665 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 685 | — |
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."
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.