No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HM LIFE INSURANCE COMPANY EIN 06-1041332 | Insurance services Service code 23 | P.O. BOX 535061 PITTSBURGH, PA 152535061 | $2.3M |
| PLANSOURCE BENEFITS ADMINISTRATION EIN 55-0800751 CONTRACT ADMINSTRATOR | Contract Administrator Service code 13 | 101 S. GARLAND AVE., SUITE 203 ORLANDO, FL 32801 | $548K |
| DELTA DENTAL OF PENNSYLVANIA EIN 23-1667011 CONTRACT ADMINSTRATOR | Contract Administrator Service code 13 | ONE DELTA DRIVE MECHANICSBURG, PA 17055 | $378K |
| CVS HEALTH EIN 05-0340626 CONTRACT ADMINSTRATOR | Contract Administrator Service code 13 | 4909 JOHN TICER DRIVE ALEXANDRIA, VA 22304 | $54K |
| BUSINESSOLVER.COM, INC. EIN 42-1503807 CONTRACT ADMINSTRATOR | Contract Administrator Service code 13 | 1025 ASHWORTH ROAD, SUITE 101 WEST DES MOINES, IA 50265 | $51K |
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 | 17,003 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 278 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 17,281 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF PENNSYLVANIA | 41 | $9K |
| Vision | VISION BENEFITS OF AMERICA | 9,532 | $287K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 9,532 | — |
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.
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.