| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DELEWARE VALLEY HEALTH CARE COALITI3 | 2980 SOUTHAMPTON RD. PHILADELPHIA, PA 19154 | DELTA DENTAL OF PENNSYLVANIA | $1K | $14K | $16K | 1.86% |
| JAMES B. WALL3 | SIX PPG PLACE, SUITE 600 PITTSBURGH, PA 15222 | STANDARD INSURANCE COMPANY | $12K | — | $12K | 7.73% |
| JAMES B. WALL3 | SIX PPG PLACE, SUITE 600 PITTSBURGH, PA 15222 | STANDARD INSURANCE COMPANY | $5K | — | $5K | 8.69% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PA PUBLIC EMPLOYEES CN 13 OF AFSCME EIN 23-7250572 EMPLOYER ORGANIZATION | Plan Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 14 | — | $257K |
| BENECARD SERVICES INC. EIN 22-2998772 | Direct payment from the plan; Claims processing Service code 12 | — | $95K |
| BUCHBINDER TUNICK & COMPANY, LLP EIN 13-1578842 AUDITOR FOR EMPL ORG. | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $29K |
| NATIONAL VISION ADMINISTRATORS, LLC EIN 74-3033381 | Claims processing; Direct payment from the plan Service code 12 | — | $26K |
| KIRSCHNER AND GARTRELL EIN 23-2113863 ATTY FOR EMPL. ORG. | Legal; Direct payment from the plan Service code 29 | — | $20K |
| CONRAD M. SIEGEL, INC. EIN 23-1669823 ACTUARY FOR EMP. ORG. | Direct payment from the plan; Actuarial Service code 11 | — | $16K |
| DELTA DENTAL OF PENNSYLVANIA EIN 23-7360639 | Direct payment from the plan; Claims processing Service code 12 | — | $14K |
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 | 5,526 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 77 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 5,603 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF PENNSYLVANIA | 0 | $839K |
| Short-term disability | STANDARD INSURANCE COMPANY | 844 | $60K |
| Long-term disability | STANDARD INSURANCE COMPANY | 844 | $162K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 844 | — |
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.