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| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS AND BLUE SHIELD OF AL EIN 63-0103830 ADMINISTRATIVE SERVICES | Contract Administrator Service code 13 | 450 RIVERCHASE PARKWAY EAST BIRMINGHAM, AL 35298 | $137K |
| DELTA DENTAL OF ARIZONA EIN 86-0274899 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 5656 W TALAVI BLVD GLENDALE, AZ 85306 | $11K |
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 | 315 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 315 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 315 | $15K |
| Long-term disability(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 53 | $16K |
| Other(3 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 315 | $339K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 315 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.