| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DEWITT INSURANCE AGENCY INC3 | 13523 BARRETT PARKWAY DRIVE #140 BALLWIN, MO 63021 | GUARDIAN | $20K | $8K | $29K | 15.35% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COVENTRY HEALTH CARE, INC. EIN 43-1372307 NONE | Insurance agents and brokers Service code 22 | 750 PRIDES CROSSING, SUITE 200 NEWARK, DE 19713 | $307K |
| LDI INTEGRATED PHARMACY SERVICES NONE | Claims processing Service code 12 | 680 CRAIG ROAD, SUITE 200 CREVE COEUR, MO 63141 | $104K |
| LAUREN ROSENKRANZ EIN 37-6039515 EMPLOYEE | Employee (plan sponsor) Service code 35 | 2000A MALL STREET, STE A COLLINSVILLE, IL 62234 | $51K |
| WOLFE NILGES NAHORSKI, PC EIN 43-1236296 NONE | Accounting (including auditing); Consulting fees Service code 10 | 1630 DES PERES RD, STE 305 ST. LOUIS, MO 63131 | $42K |
| SCHUCHAT, COOK, & WERNER EIN 43-0763010 NONE | Legal Service code 29 | 1221 LOCUST ST., STE 250 ST. LOUIS, MO 63103 | $39K |
| MERCY MANAGED BEHAVIORAL HEALTH EIN 43-1664148 NONE | Other services Service code 49 | P.O. BOX 503794 ST. LOUIS, MO 63150 | $30K |
| ERIN ENRIGHT EIN 37-6039515 EMPLOYEE | Employee (plan sponsor) Service code 35 | 2000A MALL STREET, STE A COLLINSVILLE, IL 62234 | $26K |
| SYSTEMS DESIGN ASSOCIATES EIN 43-1228887 NONE | Other services Service code 49 | 3760 S. LINDBERGH, STE 102 ST. LOUIS, MO 63127 | $18K |
| KELLY DEMATTEIS EIN 37-6039515 EMPLOYEE | Employee (plan sponsor) Service code 35 | 2000A MALL STREET, STE A COLLINSVILLE, IL 62234 | $15K |
| IBEW LOCAL 309 EIN 37-0347385 COMMON MEMBERSHIP | Other services Service code 49 | 2000A MALL STREET COLLINSVILLE, IL 62234 | $14K |
| MONETARY MANAGEMENT GROUP INC NONE | Investment advisory (plan) Service code 27 | 13537 BARRETT PARKWAY DRIVE, SUITE BALLWIN, MO 63021 | $13K |
| UMB INVESTMENT SERVICES EIN 44-0194180 NONE | Soft dollars commissions; Investment advisory (plan) Service code 27 | 201 EAST MAIN ST. COLLINSVILLE, IL 62234 | $11K |
| BMO HARRIS BANK, N.A. EIN 39-1186267 NONE | Soft dollars commissions; Investment advisory (plan) Service code 27 | P.O. BOX 2980 MILWAUKEE, WI 53201 | $8K |
| MILLIMAN USA EIN 91-0675641 NONE | Actuarial Service code 11 | 501 N. BROADWAY, STE 550 ST. LOUIS, MO 63102 | $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 | 640 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 245 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 885 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | COVENTRY HEALTH CARE OF MISSOURI | 899 | $304K |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF ILLINOIS | 766 | $471K |
| Vision(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 771 | $208K |
| Life insurance | GUARDIAN | 849 | $186K |
| Stop-loss / reinsurancereinsurance | COVENTRY HEALTH CARE OF MISSOURI | 899 | $174K |
| Other(2 contracts, 2 carriers) | GUARDIAN | 849 | $315K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 899 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.