| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | DELTA DENTAL OF PENNSYLVANIA | $7K | — | $7K | 4.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ASSOCIATED ADMINISTRATORS, LLC EIN 52-0904511 NONE | Direct payment from the plan; Contract Administrator Service code 13 | 911 RIDGEBROOK ROAD SPARKS, MD 21152 | $178K |
| CIGNA HEALTH CARE EIN 06-0303370 NONE | Participant communication; Other services; Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | 10490 LITTLE PUTUXENT PARKWAY COLUMBIA, MD 21044 | $139K |
| MORGAN, LEWIS & BOCKIUS, LLP EIN 23-0891050 NONE | Legal; Direct payment from the plan Service code 29 | 1111 PENNSYLVANIA AVE NW WASHINGTON, DC 20004 | $46K |
| BLANK ROME, LLP EIN 23-1311874 NONE | Legal; Direct payment from the plan Service code 29 | 1825 EYE STREET, NW WASHINGTON, DC 20006 | $23K |
| CALIBRE CPA GROUP, PLLC EIN 47-0900880 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | 7501 WISCONSIN AVENUE, 1200 WEST BETHESDA, MD 20814 | $18K |
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 | 287 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 287 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF PENNSYLVANIA | 479 | $168K |
| Vision | GROUP VISION SERVICES (FIDELITY SECURITY LIFE INSURANCE COMPANY) | 515 | $19K |
| Life insurance | BOSTON MUTUAL LIFE INSURANCE COMPANY | 302 | $69K |
| Short-term disability | BOSTON MUTUAL LIFE INSURANCE COMPANY | 302 | $69K |
| Long-term disability | BOSTON MUTUAL LIFE INSURANCE COMPANY | 302 | $69K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 515 | — |
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.