| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CORESOURCE, INC.3 Filed as: CORESOURCE INC | C/O SAM WOLOWNICK 1280 NORTH PLUM STREET LASCASTER, PA 17601 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $152K | — | $152K | 10.00% |
| CORESOURCE, INC.3 | 1701 CENTERVIEW DR., SUITE 207 LITTLE ROCK, AR 72211 | VISION SERVICE PLAN | $6K | — | $6K | 1.46% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TAKE CARE HEALTH SYSTEMS EIN 23-3057155 NONE | Contract Administrator Service code 13 | — | $2.4M |
| CORESOURCE, INC. EIN 35-1846036 NONE | Claims processing; Contract Administrator Service code 12 | — | $2.0M |
| OCCUPATIONAL HEALTH CENTERES OF DEL EIN 51-0376661 NONE | Other services Service code 49 | — | $254K |
| LEEHAR DISTRIBUTORS, INC EIN 43-0912223 NONE | Contract Administrator Service code 13 | — | $139K |
| LEWIS MARKETING GROUP EIN 26-3690562 NONE | Consulting (general) Service code 16 | — | $117K |
| DIGITAL PRINT & IMAGING, INC. EIN 71-0835148 NONE | Copying and duplicating Service code 36 | — | $95K |
| TEAM PHARMACY CONSULTING EIN 46-5635028 NONE | Consulting (general) Service code 16 | — | $30K |
| WELLCAREAMERICA EIN 81-1898301 NONE | Contract Administrator Service code 13 | — | $18K |
| FROST, PLLC EIN 71-0817652 NONE | Accounting (including auditing) Service code 10 | — | $18K |
| DELTA DENTAL OF ARKANSAS EIN 71-0561140 NONE | Contract Administrator Service code 13 | — | $7K |
| ACS - A XEROX COMPANY EIN 36-4129784 NONE | Contract Administrator Service code 13 | — | $0 |
| AETNA, INC. EIN 06-6033492 NONE | Contract Administrator Service code 13 | — | $0 |
| CHANGE HEALTHCARE EIN 20-5716594 NONE | Contract Administrator Service code 13 | — | $0 |
| RELIANT HEALTH PARTNERS EIN 47-2171660 NONE | Contract Administrator Service code 13 | — | $0 |
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 | 6,453 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 17 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 6,470 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 4,035 | $408K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 6,453 | $1.5M |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 6,453 | $1.5M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 6,453 | $1.5M |
| Stop-loss / reinsurancereinsurance | AETNA LIFE INSURANCE COMPANY | 7,614 | $2.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 7,614 | — |
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."
No prospect flags tripped on this filing.