No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| INDEPENDENT FIDUCIARY SERVICES, LLC EIN 82-2870895 PLAN SERVICE PROVIDER | Trustee (directed); Accounting (including auditing) Service code 10 | 8460 TYCO ROAD SUITE E VIENNA, VA 221822219 | $24K |
| CLIFTONLARSONALLEN LLP EIN 41-0746749 PLAN SERVICE PROVIDER | Accounting (including auditing) Service code 10 | 925 HIGHLAND POINTE DRIVE, STE 450 ROSEVILLE, CA 95678 | $5K |
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 | 83 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 83 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | COMPANION LIFE INSURANCE COMPANY | 0 | $0 |
| Dental | COMPANION LIFE INSURANCE COMPANY | 0 | $0 |
| Vision(2 contracts, 2 carriers) | COMPANION LIFE INSURANCE COMPANY | 0 | $0 |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 0 | $0 |
| Other | MAGELLAN HEALTHCARE | 0 | $0 |
| 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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.