No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENEFITS ADMINISTRATIVE SERVICES CO EIN 34-1627054 | Contract Administrator; Participant communication; Direct payment from the plan Service code 13 | — | $235K |
| BDO USA, P.C. EIN 13-5381590 | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $84K |
| MILLIMAN USA EIN 91-0675641 | Direct payment from the plan; Actuarial Service code 11 | — | $38K |
| RICHARD LICHTENSTEIN EIN 20-8994719 | Direct payment from the plan; Trustee (individual) Service code 20 | — | $33K |
| CDS ADMINISTRATORS, INC. EIN 25-1352803 | Direct payment from the plan; Contract Administrator Service code 13 | — | $29K |
| GROOM LAW GROUP EIN 52-0969534 | Legal; Direct payment from the plan Service code 29 | — | $26K |
| THE SEGAL CO. EIN 13-1835864 | Direct payment from the plan; Consulting (general) Service code 16 | — | $17K |
| PRINCIPAL | Investment management fees paid directly by plan; Investment management Service code 28 | 510 N VALLEY MILLS DRIVE, SUITE 400 WACO, TX 76710 | $17K |
| GERALD HALLIBURTON EIN 20-8994719 | Trustee (individual); Direct payment from the plan Service code 20 | — | $13K |
| JEFF KOSANKE EIN 20-8994719 | Direct payment from the plan; Trustee (individual) Service code 20 | — | $13K |
| DELTA DENTAL OF OHIO EIN 31-0685339 BENEFIT ADMIN ISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $7K |
| IAN D. LANOFF EIN 33-9329225 | Direct payment from the plan; Trustee (individual) Service code 20 | — | $6K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 180 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 180 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA HEALTH, INC. | 2 | $10K |
| Vision | VISION SERVICE PLAN | 171 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 171 | — |
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."
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.