No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS BLUE SHIELD OF VA EIN 54-0357120 NONE | Direct payment from the plan; Other services; Participant communication; Claims processing; Named fiduciary Service code 12 | — | $417K |
| SOUTHERN BENEFIT ADMINISTRATORS EIN 62-1116095 NONE | Direct payment from the plan; Plan Administrator; Consulting (general) Service code 14 | — | $334K |
| DANIELS, IRWIN & AYLOR EIN 62-1802605 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $32K |
| ARNALL GOLDEN GREGORY LLP EIN 58-0543673 NONE | Legal; Direct payment from the plan Service code 29 | — | $30K |
| EMPATHIA, INC. NONE | Other services; Claims processing; Direct payment from the plan; Participant communication Service code 12 | N17 W24 100 RIVERWOOD DR. WAUKESHA, WI 53188 | $13K |
| ATLANTA CAPITAL MANAGEMENT EIN 58-2236910 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $12K |
| TRUIST BANK EIN 58-0466330 NONE | Custodial (securities); Direct payment from the plan Service code 19 | — | $7K |
| THE YOUNGDAHL LAW FIRM PC NONE | Legal; Direct payment from the plan Service code 29 | 4203 MONTROSE BLVD, SUITE 280 HOUSTON, TX 77006 | $6K |
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 | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | 5 STAR LIFE INSURANCE COMPANY | 0 | $60K |
| Stop-loss / reinsurancereinsurance | AMALGAMATED LIFE INSURANCE COMPANY | 0 | $197K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 0 | — |
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."
Final-filing indicator set. Plan is winding down; don't waste sales effort here.