| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GROUP VISION SERVICES MGMT INC5 Filed as: GROUP VISION SERVICES | 6700 ALEXANDER BELL DRIVE, STE 200 COLUMBIA, MD 21046 | FIDELITY SECURITY LIFE INSURANCE COMPANY | — | $11K | $11K | 13.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| NATIONAL EMPLOYEE BENEFIT ADMINISTR EIN 65-0498809 NONE | Contract Administrator; Claims processing; Copying and duplicating; Other services; Plan Administrator Service code 12 | — | $413K |
| CIGNA HEALTH & LIFE INSURANCE COMPA EIN 59-1031071 NONE | Other services; Claims processing; Non-monetary compensation; Participant communication; Float revenue; Contract Administrator Service code 12 | — | $364K |
| LEGACY PROFESSIONALS, LLP EIN 32-0043599 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Accounting (including auditing) Service code 10 | — | $128K |
| SLEVIN & HART PC EIN 52-1708613 NONE | Other services; Legal Service code 29 | — | $102K |
| ELIXIR RX SOLUTIONS EIN 33-0567651 NONE | Contract Administrator; Claims processing Service code 12 | — | $46K |
| DELTA DENTAL OF MISSOURI EIN 43-0908349 NONE | Contract Administrator; Claims processing Service code 12 | — | $46K |
| SPENCER FANE, LLP EIN 44-0561981 NONE | Legal Service code 29 | — | $44K |
| BHA CONSULTING, LLC EIN 26-1384808 NONE | Consulting (general) Service code 16 | — | $35K |
| MEDEXPERT INTERNATIONAL, INC. EIN 94-3360248 NONE | Contract Administrator; Other services Service code 13 | — | $33K |
| STRATEGIC CAPITAL INVESTMENT ADVISO EIN 36-4268991 NONE | Investment advisory (plan) Service code 27 | — | $30K |
| COMMERCE TRUST COMPANY EIN 48-0962626 NONE | Custodial (securities); Trustee (bank, trust company, or similar financial institution); Investment management Service code 19 | — | $29K |
| TOP DRAWER EIN 59-1550960 NONE | Copying and duplicating Service code 36 | — | $19K |
| SEGAL SELECT INSURANCE SERVICES INC EIN 46-0619194 NONE | Consulting (general); Insurance brokerage commissions and fees Service code 16 | — | $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 | 1,186 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,186 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 1,673 | $80K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 874 | $61K |
| Stop-loss / reinsurancereinsurance | BERKSHIRE HATHAWAY SPECIALTY INSURANCE COMPANY | 879 | $582K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 874 | $61K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,673 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.