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| Provider | Services | Address | Compensation |
|---|---|---|---|
| VOYA STD ADMINISTRATOR | Contract Administrator Service code 13 | 20 WASHINGTON AVE. SOUTH MINNEAPOLIS, MN 55401 | $16K |
| DISCOVERY BENEFITS FSA ADMINISTRATOR | Contract Administrator Service code 13 | 4321 20TH AVENUE SW 701-239-6266 FARGO, ND 58103 | $6K |
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 | 553 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 557 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF KANSAS CITY | 1,368 | $7.2M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 542 | $79K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 542 | $79K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 1,407 | $473K |
| Long-term disability | RELIASTAR LIFE INSURANCE COMPANY | 1,407 | $473K |
| Other | RELIASTAR LIFE INSURANCE COMPANY | 1,407 | $473K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,407 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.