| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITMALL3 | 250 W OLD WILSON BRIDGE RD, STE 190 WORTHINGTON, OH 43085 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $2K | $6K | 15.00% |
| ASSUREDPARTNERS3 Filed as: INGROUP ASSOCIATES INC | 448 MURRY HILL CIR LANCASTER, PA 17601 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | — | $0 | 0.00% |
| BENEFITMALL3 | 250 W OLD WILSON BRIDGE RD, STE 190 WORTHINGTON, OH 43085 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $721 | $360 | $1K | 15.00% |
| ASSUREDPARTNERS3 Filed as: INGROUP ASSOCIATES INC | 448 MURRY HILL CIR LANCASTER, PA 17601 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HIGHMARK BLUE CROSS BLUE SHIELD EIN 25-0558173 N/A | Claims processing Service code 12 | — | $1.6M |
| BENEFIT PLANNERS ASSOCIATES EIN 25-1260770 N/A | Contract Administrator Service code 13 | — | $437K |
| ECKERT SEAMANS CHERIN & MELLOTT LLC EIN 43-1420563 | Legal Service code 29 | — | $57K |
| SEGAL EASTERN STATES EIN 13-1835864 N/A | Actuarial Service code 11 | — | $55K |
| STUYVESANT CAPITAL MANAGEMENT EIN 13-2953844 | Investment management Service code 28 | — | $49K |
| BROWN SCHULTZ SHERIDAN & FRITZ EIN 25-1644159 | Accounting (including auditing) Service code 10 | — | $32K |
| EXPRESS SCRIPTS EIN 43-1420563 | Claims processing Service code 12 | — | $26K |
| M&T INVESTMENT GROUP EIN 16-1626570 | Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $17K |
| CVS CAREMARK N/A | Claims processing Service code 12 | — | $13K |
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 | 4,731 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,740 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $43K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 0 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.