| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GROUP VISION SERVICES MGMT INC3 | 6700 ALEXANDER BELL DR SUITE #200 COLUMBIA, MD 21046 | DENTEGRA INSURANCE COMPANY | $13K | — | $13K | 4.00% |
| LAKESHORE BENEFIT GROUP INSURANCE3 | BROKERAGE, LLC PO BOX 670 NEW HARTFORD, CT 06057 | THE UNION LABOR LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENESYS, INC. EIN 38-2383171 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $390K |
| CONIFER HEALTH SOLUTIONS EIN 52-1964905 NONE | Other services; Direct payment from the plan; Other fees Service code 49 | — | $104K |
| AMERICAN REALTY EIN 33-0123114 NONE | Non-monetary compensation; Investment management; Investment management fees paid directly by plan Service code 28 | — | $48K |
| WITHUMSMITH+BROWN, P.C. EIN 22-2027092 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $37K |
| SLEVIN & HART, P.C. EIN 52-1708613 NONE | Direct payment from the plan; Trustee (individual) Service code 20 | — | $30K |
| SEGALL BRYANT EIN 41-1788385 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $29K |
| LOCKTON-DUNNING NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | 2100 ROSS AVE #1200 DALLAS, TX 75201 | $25K |
| PNC EIN 22-1211909 NONE | Custodial (securities); Direct payment from the plan Service code 19 | — | $23K |
| PENN CAPITAL MANAGEMENT EIN 22-2796848 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $14K |
| CHEIRON, INC. EIN 13-4215617 NONE | Consulting (general); Direct payment from the plan; Actuarial Service code 11 | — | $13K |
| OPTUMRX, INC. EIN 33-0441200 NONE | Direct payment from the plan; Other fees; Claims processing; Float revenue Service code 12 | — | $12K |
| IPS EIN 58-2432390 NONE | Direct payment from the plan; Consulting (general); Investment advisory (plan) Service code 16 | — | $10K |
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 | 1,153 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 84 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,237 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DENTEGRA INSURANCE COMPANY | 1,655 | $325K |
| Vision | FIDELITY SECURITY LIFE INSURANCE | 1,647 | $57K |
| Life insurance | THE UNION LABOR LIFE INSURANCE COMPANY | 1,202 | $40K |
| Other | THE UNION LABOR LIFE INSURANCE COMPANY | 1,202 | $40K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,655 | — |
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."
No prospect flags tripped on this filing.