| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 | 10 N PARK DR #200 HUNT VALLEY, MD 21030 | LIFE INSURANCE COMPANY OF AMERICA | — | $4K | $4K | 0.97% |
| IMA, INC.3 Filed as: IMA INC. | PO BOX 733835 DALLAS, TX 75373 | LIFE INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 0.49% |
| ASSUREDPARTNERS3 | 10 N PARK DR SUITE 200 HUNT VALLEY, MD 21030 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $2K | $2K | 1.04% |
| IMA, INC.3 Filed as: IMA INC. | PO BOX 733835 DALLAS, TX 75373 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 0.52% |
| BENEPLACE, INC.3 Filed as: BENEPLACE LLC | 9420 RESEARCH BLVD STE 100 AUSTIN, TX 78759 | CONTINENTAL AMERICAN INSURANCE COMPANY | $24K | — | $24K | 19.94% |
| ASSUREDPARTNERS3 | 10 N PARK DR0 #200 HUNT VALLEY, MD 21030 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 2.86% |
| IMA, INC.3 | 1705 17TH STREET STE 100 DENVER, CO 80202 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $565 | $565 | 1.24% |
| ASSUREDPARTNERS3 | 10 N PARK DR #200 HUNT VALLEY, MD 21030 | LIFE INSURANCE COMPANY OF NEW YORK | — | $45 | $45 | 0.76% |
| IMA, INC.3 Filed as: IMA INC. | 1705 17TH ST STE 100 DENVER, CO 80202 | LIFE INSURANCE COMPANY OF NEW YORK | — | $22 | $22 | 0.37% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UHC, INC. EIN 41-1289245 MEDICAL CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | — | $1.2M |
| MODERNHEALTH EIN 47-3490195 ADMIN | Contract Administrator; Claims processing Service code 12 | — | $292K |
| AP BENEFIT ADVISORS LLC COBRA/BENEFIT FEES | Contract Administrator; Claims processing Service code 12 | 10 N PARK DR SUITE 200 HUNT VALLEY, MD 21030 | $222K |
| EXPRESS SCRIPTS, INC. EIN 63-1157085 RX ADMIN | Contract Administrator; Claims processing Service code 12 | — | $122K |
| SEDGWICK CLAIMS MANAGEMENT SERVICES EIN 36-2685608 STD/LEAVE | Claims processing; Contract Administrator Service code 12 | — | $101K |
| DELTA DENTAL OF COLORADO EIN 83-4416613 DENTAL ADMIN | Claims processing; Contract Administrator Service code 12 | — | $61K |
| MAVEN CLINIC CO. EIN 46-5747423 ADOPTION, PREGNANCY, MATE | Direct payment from the plan; Other services Service code 49 | — | $36K |
| WEX HEALTH INC. EIN 06-1593514 FSA ADMIN | Contract Administrator; Claims processing Service code 12 | — | $26K |
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 | 1,653 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 140 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,807 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 1,268 | $281K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,653 | $215K |
| Long-term disability | LIFE INSURANCE COMPANY OF AMERICA | 1,652 | $386K |
| Other(3 contracts, 3 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 1,712 | $170K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,712 | — |
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."
No prospect flags tripped on this filing.