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| Provider | Services | Address | Compensation |
|---|---|---|---|
| AMPLIFON HEARING HEALTHCARE EIN 85-0437037 | Named fiduciary; Contract Administrator; Non-monetary compensation; Float revenue; Claims processing; Other services; Participant communication; Direct payment from the plan Service code 12 | FIFTH STREET TOWERS 150 SOUTH 5TH STREET SUITE 2300 MINNEAPOLIS, MN 55402 | $0 |
| FIT FOR LIFE EIN 38-3983812 | Contract Administrator; Other services; Participant communication; Claims processing; Named fiduciary; Non-monetary compensation; Direct payment from the plan; Float revenue Service code 12 | 833 W SOUTH BOULDER ROAD LOUISVILLE, CO 80027 | $0 |
| OMADA HEALTH, INC EIN 45-2355015 | Claims processing; Contract Administrator; Named fiduciary; Participant communication; Float revenue; Other services; Non-monetary compensation; Direct payment from the plan Service code 12 | 500 SANSOME ST SUITE 200 SAN FRANCISCO, CA 94111 | $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 | 356 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 356 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 356 | $817K |
| Dental(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 226 | $176K |
| Vision | EYE MED VISION ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE COMPANY | 395 | $26K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 301 | $68K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 265 | $22K |
| Other(4 contracts, 3 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 267 | $78K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 395 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.