No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHSMART BENEFIT SOLUTIONS EIN 55-0622025 NONE | Plan Administrator; Non-monetary compensation Service code 14 | — | $239K |
| SLEVIN & HART, P.C. EIN 52-1708613 NONE | Legal Service code 29 | 1625 MASSACHUSETTS AVE, NW, STE 450 WASHINGTON, DC 20036 | $44K |
| SAV- RX EIN 47-0527013 NONE | Claims processing Service code 12 | 224 NORTH PARK AVE. FREEMONT, NE 68025 | $38K |
| CALIBRE CPA GROUP, PLLC EIN 47-0900880 NONE | Accounting (including auditing) Service code 10 | 7501 WISCONSIN AVENUE, SUITE 1200 W BETHESDA, MD 20814 | $24K |
| DONALD T. BARNETT TRUSTEE | Trustee (individual) Service code 20 | PO BOX 274 POWELLTON, WV 25161 | $15K |
| WILLIAM H. HOWE TRUSTEE | Trustee (individual) Service code 20 | 5135 WORTHINGTON DRIVE BETHESDA, MD 20816 | $15K |
| CHEIRON, INC. EIN 13-4215617 NONE | Actuarial; Consulting (general) Service code 11 | 1750 TYSONS BOULEVARD, SUITE 1100 MCLEAN, VA 22102 | $7K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 748 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 748 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 761 | $304K |
| Prescription drug | FIDELITY SECURITY LIFE INSURANCE COMPANY | 761 | $304K |
| Stop-loss / reinsurancereinsurance | FIDELITY SECURITY LIFE INSURANCE COMPANY | 761 | $304K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 761 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.