| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PSA FINANCIAL, INC.3 Filed as: PSA FINANCIAL INC | 11311 MCCORMICK RD 5TH FLOOR HUNT VALLEY, MD 21031 | MINNESOTA LIFE INSURANCE COMPANY | $51K | $0 | $51K | 15.00% |
| BENEFIT ADVISORS SERVICES GROUP LLC3 Filed as: BENEFIT ADVISORS SERVICES GRP LLC | 1120 SANCTUARY PKWY SUITE 375 ALPHARETTA, GA 30009 | MINNESOTA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 1.00% |
| PSA FINANCIAL, INC.3 Filed as: PSA INSURANCE INC | 11311 MCCORMICK ROAD HUNT VALLEY, MD 21031 | HARTFORD LIFE AND ACCIDENT | $11K | — | $11K | 4.03% |
| PSA FINANCIAL, INC.3 Filed as: PSA FINANCIAL INC | 11311 MCCORMICK ROAD HUNT VALLEY, MD 21031 | HARTFORD LIFE AND ACCIDENT | $0 | $6K | $6K | 2.24% |
| BENEFIT ADVISORS SERVICES GROUP LLC3 Filed as: BENEFIT ADVISORS SERVICES GRP | ATTN CHRIS SCHOTT 1120 SANCTUARY PKWY STE 375 ALPHARETTA, GA 30009 | HARTFORD LIFE AND ACCIDENT | $5K | — | $5K | 1.64% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CORESOURCE, INC EIN 35-1846036 NONE | Other services; Claims processing; Plan Administrator Service code 12 | — | $593K |
| AETNA - PPO EIN 06-6033492 NONE | Claims processing; Other services Service code 12 | — | $219K |
| MULTIPLAN EIN 43-6004435 NONE | Other services; Plan Administrator; Claims processing Service code 12 | — | $59K |
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 | 1,759 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 41 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 39 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,839 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF DELAWARE | 1,902 | $1.5M |
| Vision | VISION BENEFITS OF AMERICA | 1,514 | $135K |
| Life insurance | MINNESOTA LIFE INSURANCE COMPANY | 2,569 | $342K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 1,980 | $285K |
| Stop-loss / reinsurancereinsurance | AETNA LIFE INSURANCE CO. | 1,807 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,569 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.