| Provider | Services | Address | Compensation |
|---|---|---|---|
| SAMBA BENEFIT PLAN EIN 52-1074154 EMPLOYEE | Direct payment from the plan; Employee (plan) Service code 30 | — | $2.0M |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator; Direct payment from the plan Service code 13 | — | $692K |
| RAM TECHNOLOGIES INC. EIN 23-2221740 NONE | Other services; Other fees; Direct payment from the plan Service code 49 | — | $561K |
| WITHUMSMITH+BROWN PC EIN 22-2027092 NONE | Consulting (general); Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $481K |
| COUNTERPOINT SOFTWARE INC EIN 51-0300805 NONE | Other services; Consulting (general); Direct payment from the plan Service code 16 | — | $439K |
| PNC INSTITUTIONAL INVESTMENTS EIN 25-1211909 NONE | Direct payment from the plan; Custodial (securities) Service code 19 | — | $432K |
| ZELIS PAYMENTS HOLDINGS LLC EIN 84-3069529 NONE | Other services; Direct payment from the plan Service code 49 | — | $369K |
| MAINLINE INFORMATION SYSTEMS NONE | Other services; Direct payment from the plan Service code 49 | 1700 SUMMIT LAKE DRIVE TALLAHASSEE, FL 32317 | $242K |
| OPTUMINSIGHT, INC. EIN 41-1858498 NONE | Direct payment from the plan; Other services Service code 49 | — | $191K |
| BALMAR INC (HBP) EIN 04-3725251 NONE | Other services; Direct payment from the plan; Copying and duplicating Service code 36 | — | $138K |
| HOUSE OF PRINTING INC EIN 52-0942907 NONE | Direct payment from the plan; Other services; Copying and duplicating Service code 36 | — | $137K |
| HUBBARD RADIO WASHINGTON DC,LLC EIN 27-4939278 NONE | Direct payment from the plan; Other fees; Other services Service code 49 | — | $110K |
| CAROUSEL INDUSTRIES OF NORTH AMERIC EIN 06-1502254 NONE | Other services; Direct payment from the plan Service code 49 | — | $95K |
| EYEMED VISION CARE EIN 80-0773195 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $88K |
| CHANGE HEALTHCARE OPERATIONS LLC EIN 20-5731067 NONE | Other services; Direct payment from the plan Service code 49 | — | $84K |
| HYLAND SOFTWARE, INC EIN 64-1699247 NONE | Direct payment from the plan; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $64K |
| MARY LIVINGSTON NONE | Consulting (general); Direct payment from the plan Service code 16 | 1406 KNIGHTS BRIDGE TURN CROFTON, MD 21114 | $64K |
| COMMONWEALTH DIGITAL OFFICE NONE | Direct payment from the plan; Other services Service code 49 | 21205 RIDGETOP CIRCLE STERLING, VA 20166 | $53K |
| JOHN MARTUCCI NONE | Consulting (general); Direct payment from the plan; Accounting (including auditing) Service code 10 | 405 NAUTICAL LANE OCEAN CITY, MD 21842 | $50K |
| WILLIAM P O'HANLON PRESIDENT SAMBA BOD | Direct payment from the plan; Other services; Consulting (general) Service code 16 | 2496 DURHAM PLACE JEFFERSONTON, VA 22724 | $46K |
| CIGNA EIN 59-1031071 NONE | Direct payment from the plan; Contract Administrator; Claims processing; Named fiduciary; Float revenue; Non-monetary compensation; Other services; Participant communication Service code 12 | — | $46K |
| ZIXCORP SYSTEMS INC NONE | Other services; Direct payment from the plan Service code 49 | PO BOX 650823 DALLAS, TX 75265 | $45K |
| WINDSTREAM NONE | Other services; Direct payment from the plan Service code 49 | PO BOX 9001013 LOUISVILLE, KY 40290 | $43K |
| DATABANK HOLDINGS EIN 83-0409949 NONE | Other services; Direct payment from the plan Service code 49 | — | $29K |
| CRAYON SOFTWARE EXPERTS LLC EIN 47-2237420 NONE | Other services; Direct payment from the plan Service code 49 | — | $27K |
| ERMER & SUTER, PLLC EIN 26-1616418 DAVID ERMER-SECRETARY BOD | Legal; Direct payment from the plan Service code 29 | — | $25K |
| LYNN CHANG NONE | Direct payment from the plan; Consulting (general) Service code 16 | 114 BECKWITH STREET GAITHERSBURG, MD 20878 | $23K |
| NTIRETY, INC EIN 26-4826233 NONE | Other services; Direct payment from the plan Service code 49 | — | $20K |
| PROMOSANDLOGOS.COM INC EIN 20-1951023 NONE | Other services; Other fees; Direct payment from the plan Service code 49 | — | $16K |
| CARANGI & ASSOCIATES INC NONE | Actuarial; Direct payment from the plan Service code 11 | 20530 ROUTE 19 SUITE 4 CRANBERRY TOWNSHIP, PA 16066 | $9K |
| FULFILLMENT SOLUTIONS INC EIN 54-1899136 NONE | Copying and duplicating; Direct payment from the plan Service code 36 | — | $7K |
| PAMELA CUMMINGS NONE | Consulting (general); Direct payment from the plan Service code 16 | 12 CARRIAGE WALK CT. GAITHERSBURG, MD 20879 | $6K |
| VW BROWN INSURANCE SERVICE LLC EIN 26-0274369 NONE | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $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 | 108,563 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 108,563 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AETNA LIFE INSURANCE CO. | 4,474 | $1.6M |
| Life insurance(4 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 82,396 | $13.3M |
| Other(3 contracts, 3 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 12,732 | $7.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 82,396 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.