| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TENTH DOT BENEFITS SOLUTIONS LLC3 | 444 LIBERTY AVE STE 750 PITTSBURGH, PA 152221224 | METROPOLITAN LIFE INSURANCE COMPANY | $11K | $6K | $17K | 2.66% |
| TENTH DOT BENEFITS SOLUTIONS LLC3 | 444 LIBERTY AVE STE 750 PITTSBURGH, PA 152221224 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $779 | $779 | 2.51% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HIGHMARK EIN 54-1637426 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $143K |
| AON HEWITT EIN 36-3051915 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $77K |
| ONE EXCHANGE EIN 91-1774434 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $44K |
| AETNA EIN 23-2710210 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $8K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14,878 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 14,878 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | HIGHMARK INC. | 246 | $318K |
| Dental(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 19,806 | $154K |
| Vision | AETNA LIFE INSURANCE CO. | 1,335 | $153K |
| Life insurance(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 13,233 | $659K |
| Prescription drug | INDEPENDENCE BLUE CROSS | 79 | $83K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 19,806 | — |
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.