No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CVS NONE | Other fees Service code 99 | — | $2.2M |
| ZENITH AMERICAN SOLUTIONS EIN 25-1139840 NONE | Claims processing; Contract Administrator Service code 12 | — | $510K |
| ZELIS EIN 86-1040704 NONE | Claims processing Service code 12 | — | $111K |
| CAREFIRST PPO FEE EIN 52-1330940 NONE | Claims processing; Other fees Service code 12 | — | $101K |
| O'DON & O'DON EIN 53-0120528 NONE | Legal Service code 29 | — | $71K |
| BHA CONSULTING EIN 26-1384808 NONE | Actuarial Service code 11 | — | $70K |
| AMERICAN HEALTH HOLDING INC EIN 31-1368946 NONE | Other services Service code 49 | — | $65K |
| CALIBRE CPA GROUP EIN 47-0900880 NONE | Accounting (including auditing) Service code 10 | — | $25K |
| WELLS FARGO NONE | Custodial (securities) Service code 19 | — | $7K |
| SEGAL MARCO ADVISORS EIN 13-2646110 NONE | Investment advisory (plan) Service code 27 | — | $6K |
| STATE STREET GLOBAL ADVISORS EIN 81-4077137 NONE | Custodial (securities); Custodial (other than securities); Investment management fees paid directly by plan Service code 18 | — | $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 | 750 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 59 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 809 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DOMINION NATIONAL | 781 | $197K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 800 | $217K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 800 | — |
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."
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.