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| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHSCOPE EIN 71-0847266 ADMINISTRATOR | Other services; Recordkeeping fees; Other fees; Contract Administrator; Account maintenance fees; Claims processing Service code 12 | — | $616K |
| DELTA DENTAL OF MISSOURI EIN 43-0908349 NONE | Claims processing; Contract Administrator Service code 12 | — | $30K |
| PAYLOCITY CORPORATION THIRD PARTY | Contract Administrator Service code 13 | 1400 AMERICAN LANE SCHAUMBURG, IL 60173 | $14K |
| UNITED OF OMAHA LIFE INSURANCE COMP EIN 47-0322111 NONE | Claims processing; Contract Administrator Service code 12 | — | $11K |
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 | 485 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 485 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 420 | $61K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 485 | $35K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 484 | $46K |
| Stop-loss / reinsurancereinsurance | AETNA | 423 | $383K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 485 | $106K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 485 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.