| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JN SAVASTA CORP3 Filed as: J N SAVASTA CORP | 1350 BROADWAY RM 410 NEW YORK, NY 10018 | RELIANCE STANDARD | $3K | — | $3K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GEMGROUP EIN 25-1139840 NONE | Contract Administrator Service code 13 | — | $276K |
| CAREFIRST PPO EIN 52-1187907 NONE | Other fees; Claims processing Service code 12 | — | $50K |
| AMERICAN HEALTH HOLDING EIN 31-1368946 NONE | Other services Service code 49 | — | $41K |
| SAVASTA & CO. EIN 13-3879959 NONE | Actuarial Service code 11 | — | $39K |
| MCCHESNEY & DALE EIN 52-1842141 NONE | Legal Service code 29 | — | $33K |
| APS HEALTHCARE EIN 42-1413902 NONE | Other services Service code 49 | — | $23K |
| STRATOSE EIN 26-1790538 NONE | Other services Service code 49 | — | $22K |
| SALTER & COMPANY, LLC EIN 20-8078757 NONE | Accounting (including auditing) Service code 10 | — | $9K |
| WELLS FARGO EIN 41-0449260 NONE | Custodial (securities) Service code 19 | — | $6K |
| SEGAL COMPANY EIN 13-1835684 NONE | Investment advisory (plan) Service code 27 | — | $5K |
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 | 652 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 93 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 745 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF PENNSYLVANIA | 735 | $351K |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 730 | $55K |
| Life insurance | RELIANCE STANDARD | 106 | $23K |
| Other | RELIANCE STANDARD | 106 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 735 | — |
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.