| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TRILOGY PURCHASING ALLIANCE LLC3 Filed as: TRILOGY PURCHASING ALLIANCE, LLC | 1601 S STATE ST STE 600 EDMOND, OK 73013 | DELTA DENTAL | $7K | $27K | $34K | 11.10% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| KEMPTON GROUP ADMINISTRATORS EIN 73-1201547 NONE | Contract Administrator Service code 13 | P.O. BOX 54889 OKLAHOMA CITY, OK 731541889 | $225K |
| FIRST HEALTH GROUP, CORP EIN 20-1736437 NONE | Claims processing Service code 12 | 9229 WARD PARKWAY, SUITE 300 KANSAS CITY, MO 64114 | $65K |
| SCRIPT CARE, LTD EIN 76-0621375 NONE | Claims processing Service code 12 | PO BOX 4356, DEPT 2262 HOUSTON, TX 77210 | $38K |
| MEDCOM CARE MANAGEMENT, INC. EIN 72-1339762 NONE | Claims processing Service code 12 | — | $15K |
| SOMERSET CPAS, P.C. EIN 20-1717681 NONE | Accounting (including auditing) Service code 10 | 3925 RIVER CROSSING PARKWAY INDIANAPOLIS, IN 46240 | $12K |
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 | 608 | 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) | 608 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL | 579 | $304K |
| Stop-loss / reinsurancereinsurance | AMERICAN FIDELITY ASSURANCE COMPANY | 608 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 608 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.