No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BMO HARRIS BANK, N.A. EIN 36-2085229 NONE | Shareholder servicing fees; Trustee (directed); Recordkeeping fees; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Participant loan processing; Copying and duplicating; Trustee (bank, trust company, or similar financial institution); Account maintenance fees; Float revenue; Distribution (12b-1) fees; Custodial (securities) Service code 15 | — | $32K |
| ONEAMERICA RETIREMENT SERVICES LLC EIN 46-5378846 NONE | Shareholder servicing fees; Participant loan processing; Participant communication; Recordkeeping and information management (computing, tabulating, data processing, etc.); Distribution (12b-1) fees; Direct payment from the plan; Recordkeeping fees Service code 15 | — | $11K |
| BAKER TILLY VIRCHOW KRAUSE, LLP EIN 39-0859910 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $8K |
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 | 424 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 79 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 2 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 505 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | MET LIFE INSURANCE COMPANY | 5 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.