No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAPFINANCIAL PARTNERS LLC EIN 26-0058143 NONE | Investment advisory (plan); Investment management fees paid indirectly by plan Service code 27 | — | $59K |
| ONEAMERICA RETIREMENT SERVICES LLC EIN 46-5378846 NONE | Participant communication; Distribution (12b-1) fees; Recordkeeping and information management (computing, tabulating, data processing, etc.); Copying and duplicating; Direct payment from the plan; Shareholder servicing fees; Recordkeeping fees Service code 15 | — | $2K |
| BMO HARRIS BANK NA EIN 36-2085229 NONE | Investment management; Trustee (bank, trust company, or similar financial institution); Custodial (securities); Trustee (directed); Float revenue; Soft dollars commissions Service code 19 | — | $0 |
| BMO HARRIS BANK, NA | Trustee (directed); Investment management; Soft dollars commissions; Trustee (bank, trust company, or similar financial institution); Custodial (securities); Float revenue Service code 19 | — | $0 |
| ONEAMERICA RETIREMENT SERVICES, LLC | Shareholder servicing fees; Distribution (12b-1) fees; Participant communication; Recordkeeping fees; Copying and duplicating; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $0 |
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 | 267 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 93 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 361 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | GENERAL AMERICA LIFE INSURANCE | 1 | $2K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1 | — |
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.