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| Provider | Services | Address | Compensation |
|---|---|---|---|
| ACCURISK/NATIONWIDE INSURANCE ADMIN | Claims processing Service code 12 | 10 SOUTH LASALLE ST STE 3450 CHICAGO, IL 60603 | $278K |
| EDUMEDICS LLC DBA SENTRY HEALTH ADMIN | Claims processing Service code 12 | 7410 NEW LA GRANGE RD STE 205 LOUISVILLE, KY 40222 | $57K |
| ANCHOR BENEFIT CONSULTING, INC ADMIN | Claims processing Service code 12 | 2400 MAITLAND CENTER PARKWAY STE. 111 MAITLAND, FL 32751 | $47K |
| ECM INSURANCE BROKER | Insurance agents and brokers Service code 22 | 532 S MAIN ST STE. 300 GREENVILLE, SC 29601 | $33K |
| LIFECYCLE II, LLC ADMIN | Claims processing Service code 12 | 4000 PARK RD CHARLOTTE, NC 28209 | $9K |
| UPSTATE CONCIERGE MANAGEMENT LLC ADMIN | Claims processing Service code 12 | 216 RIVER ST 3RD FLOOR TROY, NY 12180 | $9K |
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 | 298 | 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. |
| Total participants (= "Plan participants" tile) | 298 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 294 | $233K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 294 | $233K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 294 | $233K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 294 | $233K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 294 | $233K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 298 | $355K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 298 | — |
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.