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| Provider | Services | Address | Compensation |
|---|---|---|---|
| INTEGRA EMPLOYER HEALTH DBA MAESTRO EIN 56-1392505 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $74K |
| STRATEBEN, INC. EIN 20-1643248 PLAN CONSULTANT | Consulting (general) Service code 16 | — | $70K |
| MORGAN STANLEY SMITH BARNEY LLC EIN 20-8764829 NONE | Other fees; Investment advisory (plan); Securities brokerage; Other investment fees and expenses; Other services; Securities brokerage commissions and fees; Custodial (securities); Direct payment from the plan Service code 19 | — | $40K |
| CURTIS BLAKELY & CO INC. EIN 75-1545734 AUDITOR | Accounting (including auditing) Service code 10 | — | $20K |
| PHCS EIN 04-3138814 PPO PROVIDER | Contract Administrator Service code 13 | — | $11K |
| SAGE ADVISORY SERVICES LTD EIN 74-2798841 NONE | Investment management fees paid directly by plan Service code 51 | — | $5K |
| RETIREMENT HORIZONS INC. EIN 76-0551734 NONE | Actuarial Service code 11 | — | $2K |
| ABBEY CAPITAL FUNDS EIN 39-0281260 NONE | Other fees; Other services Service code 49 | — | $0 |
| INVESCO FUNDS EIN 58-2287224 NONE | Other services; Other fees Service code 49 | — | $0 |
| LAZARD ASSET MANAGEMENT EIN 05-0530199 NONE | Other fees; Other services Service code 49 | — | $0 |
| LOCORR FUNDS EIN 39-1982827 NONE | Other fees; Other services Service code 49 | — | $0 |
| MORGAN STANLEY BANK N.A. EIN 36-3707380 NONE | Other commissions; Securities brokerage; Other services Service code 33 | — | $0 |
| MORGAN STANLEY PRIVATE BANK NA EIN 22-3458456 NONE | Securities brokerage; Other services; Other commissions Service code 33 | — | $0 |
| OAKMARK FUNDS EIN 52-2257882 NONE | Other fees; Other services Service code 49 | — | $0 |
| PGIM INVESTMENTS EIN 22-3468527 NONE | Other fees; Other services Service code 49 | — | $0 |
| PIMCO INSTITUTIONAL FUNDS EIN 95-2632339 NONE | Other services; Other fees Service code 49 | — | $0 |
| THORNBURG FUNDS EIN 31-0487145 NONE | Other fees; Other services Service code 49 | — | $0 |
| TOUCHSTONE FUNDS EIN 31-0487145 NONE | Other services; Other fees Service code 49 | — | $0 |
| VIRTUS EMERGING MARKETS EIN 95-4191764 NONE | Other services; Other fees Service code 49 | — | $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 | 205 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 135 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 340 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 316 | $119K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 212 | $150K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 212 | $150K |
| Prescription drug | EXPRESS SCRIPTS, INC. | 19 | $46K |
| Stop-loss / reinsurancereinsurance | ACCRISK/NATIONWIDE LIFE INSURANCE COMPANY | 210 | $469K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 316 | $119K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 316 | — |
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.