| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CANYON RE, LLC3 | 1400 BUFORD HWY, SUITE A-3 BUFORD, GA 30518 | ZURICH AMERICAN INSURANCE COMPANY | $37K | — | $37K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MAGNACARE EIN 11-3410766 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $520K |
| INCLUDED HEALTH INC. EIN 45-3580052 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $116K |
| M EGENER EIN 35-0911491 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $109K |
| FOSTER & FOSTER EIN 59-1921114 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $92K |
| P KEENAN EIN 35-0911491 ADMINISTRATOR | Plan Administrator; Direct payment from the plan Service code 14 | — | $69K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Accounting (including auditing); Direct payment from the plan Service code 10 | — | $64K |
| HAGBERG & ASSOCIATES, P.C. EIN 01-0598991 NONE | Other services; Legal; Direct payment from the plan Service code 29 | — | $59K |
| M SCZURKO EIN 35-0911491 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $59K |
| M PARAMANTGIS EIN 35-0911491 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $56K |
| MARQUETTE ASSOCIATES EIN 36-3485298 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $55K |
| SAGE ADVISORY SERVICES LTD CO EIN 74-2798841 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $34K |
| PNC BANK EIN 22-1146430 NONE | Float revenue; Soft dollars commissions; Investment management fees paid directly by plan; Custodial (securities) Service code 19 | — | $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 | 974 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 516 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,490 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC | 695 | $1.8M |
| Vision | VISION SERVICE PLAN | 1,512 | $156K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,092 | $15K |
| Prescription drug | SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC | 695 | $1.8M |
| Stop-loss / reinsurancereinsurance | ZURICH AMERICAN INSURANCE COMPANY | 961 | $744K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 1,092 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,512 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.