| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FRISSORA & ASSOCIATES LLC3 | 103 BRADFORD RD STE 105 WEXFORD, PA 15090 | RELIASTAR LIFE INSURANCE COMPANY | — | $24K | $24K | 3.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MERITAIN HEALTH EIN 16-1264154 NONE | Claims processing Service code 12 | 300 CORPORATE PKWY 100S AMHERST, NY 14226 | $76K |
| PATRICIA BURSON DORMAN EIN 25-1158956 EMPLOYEE | Employee (plan) Service code 30 | — | $75K |
| BRIDGEWAY BENEFIT TECHNOLOGIES NONE | Other services Service code 49 | 3000 SOUTH LENOLA ROAD MAPLE SHADE, NJ 08052 | $38K |
| FLORES & ASSOCIATES NONE | Claims processing Service code 12 | PO BOX 63238 CHARLOTTE, NC 28263 | $22K |
| DICLAUDIO & KRAMER, LLC EIN 27-0889793 NONE | Accounting (including auditing) Service code 10 | — | $16K |
| MARINER INSTITUTIONAL LLC NONE | Consulting (general) Service code 16 | 531 W. MORSE BLVD WINTER PARK, FL 32789 | $14K |
| MEYER UNKOVIC AND SCOTT EIN 25-1008021 NONE | Legal Service code 29 | — | $10K |
| USI CONSULTING GROUP EIN 34-1213174 NONE | Actuarial Service code 11 | — | $9K |
| LOGAN, METTLEY & NEWCOMER EIN 33-1365351 NONE | Legal Service code 29 | — | $7K |
| FRISSORA & ASSOCIATES NONE | Consulting (general) Service code 16 | 103 BRADFORD RD, SUITE 105 WEXFORD, PA 15090 | $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 | 216 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 60 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 276 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK INC. - FREEDOM BLUE | 115 | $248K |
| Vision(2 contracts) | VISION BENEFITS OF AMERICA | 271 | $44K |
| Stop-loss / reinsurancereinsurance | RELIASTAR LIFE INSURANCE COMPANY | 702 | $804K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 702 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.