| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERITAIN HEALTH | 300 CORPORATE PARKWAY AMHERST, NY 14226 | HCC LIFE INSURANCE COMPANY | $2K | — | $2K | 1.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MERITAIN HEALTH EIN 16-1264154 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 300 CORPORATE PARKWAY AMHERST, NY 14226 | $91K |
| CUSTOM DESIGN BENEFITS, INC. EIN 82-0563218 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 5589 CHEVIOT RD CINCINNATI, OH 45247 | $27K |
| HEALTH WORKS EIN 31-1632833 HEALTH SCREENING PROVIDER | Consulting (general) Service code 16 | 3914 OAK STREET CINCINNATI, OH 45227 | $8K |
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 | 143 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HCC LIFE INSURANCE COMPANY | 142 | $185K |
| Prescription drug | HCC LIFE INSURANCE COMPANY | 142 | $185K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 142 | $185K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 142 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.