No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| A&A DRUG CO. DBA SAV-RX EIN 47-0527013 NONE | Claims processing; Direct payment from the plan; Insurance services Service code 12 | — | $385K |
| ANTHEM INSURANCE COMPANIES, INC. EIN 35-0781558 NONE | Claims processing; Contract Administrator; Direct payment from the plan; Other services; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $152K |
| ROBERT PUZA EIN 51-6113680 EMPLOYEE | Plan Administrator; Direct payment from the plan; Employee (plan) Service code 14 | — | $65K |
| YVONNE KLOOTWYK EIN 51-6113680 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $47K |
| UNITED ACTUARIAL SERVICES INC. EIN 35-2156428 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $43K |
| AMY GORBY EIN 51-6113680 EMPLOYEE | Employee (plan); Direct payment from the plan Service code 30 | — | $43K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $42K |
| LEDBETTER PARISI, LLC EIN 03-0599899 NONE | Legal; Direct payment from the plan Service code 29 | — | $33K |
| INNOVATIVE SOFTWARE SOLUTIONS, INC. EIN 23-2182079 NONE | Other services; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $21K |
| MARQUETTE ASSOCIATES, INC. EIN 36-3485298 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $6K |
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 | 225 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 42 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 267 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | HARTFORD LIFE AND ACCIDENT | 211 | $13K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 211 | $13K |
| Stop-loss / reinsurancereinsurance | ANTHEM INSURANCE COMPANIES, INC. | 267 | $257K |
| Other | HARTFORD LIFE AND ACCIDENT | 211 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 267 | — |
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.