No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ADP EIN 13-3038745 CONTRACT ADMINISTRATOR | Direct payment from the plan; Contract Administrator Service code 13 | — | $221K |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Contract Administrator; Direct payment from the plan; Claims processing Service code 12 | — | $165K |
| KEYBANK, NA EIN 34-0797057 TRUSTEES | Trustee (bank, trust company, or similar financial institution); Direct payment from the plan Service code 21 | — | $55K |
| FINDLEY DAVIES EIN 34-1213174 ACTUARY | Actuarial; Direct payment from the plan Service code 11 | — | $20K |
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CONTRACT ADMINISTRATOR | Direct payment from the plan; Contract Administrator; Claims processing; Other services Service code 12 | — | $12K |
| THE CHELKO CONSULTING GROUP CONSULTING | Direct payment from the plan; Consulting (general) Service code 16 | 24651 CENTER RIDGE ROAD SUITE 110 WESTLAKE, OH 44145 | $12K |
| MEDICAL MUTUAL OF OHIO EIN 34-1922587 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $5K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 824 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 90 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 914 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 26 | $69K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 26 | — |
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.