No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS BLUE SHIELD CLAIMS PROCESSING | Float revenue; Other services; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | 120 MONUMENT CIRCLE INDIANAPOLIS, IN 46204 | $199K |
| BENESYS, INC. THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | 3660 STUTZ DRIVE, STE 101 CANFIELD, OH 44406 | $66K |
| SEGAL BENEFIT CONSULTANT | Consulting (general) Service code 16 | 1111 SUPERIOR AVENUE CLEVELAND, OH 44114 | $63K |
| PNC BANK CUSTODIAN | Custodial (other than securities); Custodial (securities) Service code 18 | 300 FIFTH AVE PITTSBURGH, PA 15222 | $27K |
| FAULKNER, HOFFMAN & PHILLIPS ATTORNEY | Legal Service code 29 | 20445 EMERALD PARKWAY DR CLEVELAND, OH 44135 | $17K |
| YURCHYK & DAVIS CPA'S, INC EIN 34-1638235 AUDITOR | Accounting (including auditing) Service code 10 | — | $12K |
| PARSONS RISK STRATEGIES, LLC ACTUARY | Actuarial Service code 11 | 347 TIMERLANE DRIVE AVON LAKE, OH 44012 | $6K |
| AMERICAN GRAPHICS PRINTING CO. PRINTING SERVICES | Copying and duplicating Service code 36 | 34895 GROESBECK CLINTON TWP, MI 48035 | $5K |
| MARINER INSTITUTIONAL LLC INVESTMENT CONSULTANT | Investment advisory (plan) Service code 27 | 531 WEST MORSE BLVD ST200 WINTER PARK, FL 32789 | $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 | 347 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 23 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 370 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | BERKSHIRE HATHAWAY SPECIALTY INSURANCE COMPANY | 370 | $220K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 370 | — |
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.
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.