| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SILBERSTEIN INSURANCE GROUP3 | 2850 QUARRY LAKE DRIVE SUITE 303 BALTIMORE, MD 21209 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $110 | $4K | 15.43% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $513 | $513 | 2.00% |
| SILBERSTEIN INSURANCE GROUP3 | 2850 QUARRY LAKE DRIVE SUITE 303 BALTIMORE, MD 21209 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $133 | $2K | 7.58% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $455 | $455 | 2.00% |
| SILBERSTEIN INSURANCE GROUP3 | 2850 QUARRY LAKE DRIVE SUITE 303 BALTIMORE, MD 21209 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $77 | $2K | 10.44% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $353 | $353 | 2.00% |
| SILBERSTEIN INSURANCE GROUP3 | 2850 QUARRY LAKE DRIVE SUITE 303 BALTIMORE, MD 21209 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $383 | $11 | $394 | 15.45% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $51 | $51 | 2.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE LOOMIS COMPANY EIN 23-2238132 TPA AND CLAIMS PROCESSOR | Plan Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 850 N PARK ROAD PO BOX 7011 WYOMISSING, PA 19610 | $59K |
| SILBERSTEIN INSURANCE GROUP, LLC EIN 52-2132804 INSURANCE BROKER | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | 2850 QUARRY LAKE DRIVE SUITE 303 BALTIMORE, MD 21209 | $45K |
| CIGNA EIN 35-2029627 INSURANCE CARRIER | Insurance services Service code 23 | — | $25K |
| HINES & ASSOCIATES EIN 36-3545085 CLAIMS CONSULTING | Consulting fees Service code 70 | 115 EAST HIGHLAND AVENUE ELGIN, IL 60120 | $13K |
| ZELIS CLAIMS INTEGRITY, INC EIN 86-1040704 CLAIMS PROCESSOR | Claims processing Service code 12 | 2 CROSSROADS DRIVE BEDNINSTER, NJ 07921 | $8K |
| TELEDOC HEALTH, INC. EIN 04-3705970 HEALTH SERVICE PROVIDER | Other services Service code 49 | 2 MANHATTANVILLE ROAD PURCHASE, NY 10577 | $2K |
| EVOLUTIONS HEALTHCARE SYSTEMS EIN 59-3139483 INSURANCE CARRIER | Insurance services Service code 23 | 8406 MASSACHUSETTS AVE SUITE A-1 NEW PORT RICHEY, FL 34653 | $748 |
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 | 145 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 146 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 145 | $26K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 145 | $18K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 145 | $23K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 109 | $482K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 145 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 145 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.