No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENEFITS ADMINISTRATIVE SERVICES CO EIN 34-1627054 | Participant communication; Direct payment from the plan; Contract Administrator Service code 13 | — | $125K |
| CIUNI & PANICHI, INC. EIN 34-1322309 | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $44K |
| JOHN T. GRIGSBY EIN 20-8994792 | Trustee (individual); Direct payment from the plan Service code 20 | — | $42K |
| MILLIMAN EIN 91-0675641 | Actuarial; Direct payment from the plan Service code 11 | — | $26K |
| DREW DAVIDOFF EIN 20-8994792 | Trustee (individual); Direct payment from the plan Service code 20 | — | $22K |
| RICHARD LICHTENSTEIN EIN 20-8994792 | Trustee (individual); Direct payment from the plan Service code 20 | — | $22K |
| CDS ADMINSTRATORS, INC. EIN 25-1352803 | Direct payment from the plan; Contract Administrator Service code 13 | — | $8K |
| PRINCIPAL | Contract Administrator; Direct payment from the plan Service code 13 | 510 N VALLEY MILLS DRIVE, SUITE 400 WACO, TX 76710 | $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 | 55 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 55 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 56 | $2K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 56 | — |
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.