No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LIBERTY LIFE ASSURANCE CO. EIN 04-6076039 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $462K |
| HORIZON BLUE CROSS BLUE SHIELD EIN 22-0999690 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $151K |
| PRYAMIS GLOBAL ADVISORS TRUST CO NONE | Investment management; Investment management fees paid directly by plan Service code 28 | 26332 NETWORK PLACE CHICAGO, IL 66073 | $58K |
| RELIASTAR LIFE INSURANCE CO. EIN 41-0451140 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $56K |
| MEDCO HEALTH SOLUTIONS EIN 22-3461740 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $34K |
| WILLIS TOWER WATSON NVT SERV, INC. EIN 52-1868818 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $29K |
| WEISERMAZARS LLP EIN 13-1459550 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $27K |
| WELLS FARGO EIN 94-1347393 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Trustee (bank, trust company, or similar financial institution); Direct payment from the plan; Shareholder servicing fees; Recordkeeping fees; Investment management; Float revenue; Distribution (12b-1) fees; Claims processing Service code 12 | — | $19K |
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 | 702 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 702 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 575 | $419K |
| Stop-loss / reinsurancereinsurance | RELIASTAR LIFE INSURANCE COMPANY | 86 | $60K |
| Other | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 575 | $419K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 575 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.