| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AP BENEFIT ADVISORS, LLC3 | 10 N PARK DR HUNT VALLEY, MD 21030 | SUN LIFE ASSURANCE COMPANY OF CANADA | $392K | — | $392K | 6.95% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF PENNSYLVANIA EIN 23-1667011 DENTAL ADMIN | Contract Administrator; Claims processing Service code 12 | — | $361K |
| ISOLVED HCM, LLC EIN 81-3737069 COBRA/FSA ADMIN | Claims processing Service code 12 | — | $163K |
| EYEMED EIN 43-0949844 VISION ADMIN | Claims processing; Contract Administrator Service code 12 | — | $55K |
| CAPITAL ADVANTAGE ASSURANCE CO. EIN 45-5492167 MED/RX ADMIN | Contract Administrator; Claims processing Service code 12 | — | -$2.9M |
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 | 12,613 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 262 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 6,033 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 18,908 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 558 | $5.0M |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 12,613 | $5.6M |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 12,613 | $5.6M |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 12,613 | $5.6M |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 12,613 | $6.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 12,613 | — |
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.