| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DELAWARE VALLEY HEALTH CARE | — | DELTA DENTAL OF PENNSYLVANIA | $575 | — | $575 | 0.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 62-1298242 NONE | Direct payment from the plan; Participant communication; Contract Administrator; Other services; Claims processing Service code 12 | 900 COTTAGE GROVE ROAD BLOOMFIELD, CT 06002 | $140K |
| 90 DEGREE BENEFITS COMPANY EIN 25-1260770 NONE | Direct payment from the plan; Contract Administrator Service code 13 | 6345 FLANK DRIVE HARRISBURG, PA 17112 | $128K |
| BENECARD PRESCRIPTION BENEFIT EIN 22-2998772 NONE | Claims processing; Direct payment from the plan Service code 12 | 1200 ROUTE 46 WEST CLINTON, NJ 07013 | $49K |
| CBIZ EIN 23-1700844 NONE | Actuarial Service code 11 | 1845 WALNUT STREET PHILADELPHIA, PA 19103 | $27K |
| O'DONOGHUE AND O'DONOGHUE EIN 53-0120528 NONE | Legal; Direct payment from the plan Service code 29 | 325 CHESTNUT STREET PHILADELPHIA, PA 19106 | $13K |
| ALAN ROSS & COMPANY EIN 20-5367494 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | 10 HEARTHSTONE COURT SUITE 100 READING, PA 19606 | $13K |
| PFM ASSET MANAGEMENT LLC EIN 23-3087064 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | PO BOX 62923 BALTIMORE, MD 21264 | $8K |
| DELTA DENTAL EIN 23-1667011 NONE | Claims processing; Direct payment from the plan Service code 12 | 5073 RITTER ROAD MECHANICSBURG, PA 17055 | $7K |
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 | 319 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 24 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 343 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF PENNSYLVANIA | 663 | $115K |
| Stop-loss / reinsurancereinsurance | US FIRE INSURANCE COMPANY | 319 | $621K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 663 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.