| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NONE | — | KAISER FOUNDATION HEALTH PLAN INC | — | — | $0 | 0.00% |
| BROKERAGE CONCEPTS INC5 | 801 LAKEVIEW DRIVE, SUITE 301 BLUE BELL, PA 19422 | STANDARD SECURITY LIFE | — | $44K | $44K | 20.62% |
| NONE | — | VISION SERVICE PLAN | — | — | $0 | 0.00% |
| NONE | — | UNITED OF OMAHA LIFE INSURANCE CO | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ATPA EIN 94-3187938 NONE | Contract Administrator; Direct payment from the plan; Claims processing Service code 12 | — | $174K |
| BENSYS ADMINISTRATORS EIN 38-2383171 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $120K |
| RAEL & LETSON EIN 94-1457076 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $67K |
| KRAW LAW GROUP EIN 77-0171216 NONE | Legal; Direct payment from the plan Service code 29 | — | $56K |
| BLUE SHIELD EIN 94-2822302 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $51K |
| HEALTHNOW NONE | Direct payment from the plan; Claims processing Service code 12 | 801 LAKEVIEW DRIVE, STE 301 BLUE BELL, PA 19422 | $23K |
| HEMMING MORSE LLP EIN 30-0702322 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $22K |
| LOOMIS SAYLES EIN 94-1554520 NONE | Investment management fees paid directly by plan; Investment advisory (plan) Service code 27 | — | $19K |
| US BANK EIN 31-0841368 NONE | Direct payment from the plan; Custodial (securities) Service code 19 | — | $16K |
| ALAN BILLER & ASSOCIATES EIN 94-2854958 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $11K |
| KAUFMANN & GOBLE EIN 94-2614826 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $10K |
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 | 519 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 58 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 577 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | STANDARD SECURITY LIFE | 244 | $214K |
| Dental | STANDARD SECURITY LIFE | 244 | $214K |
| Vision | VISION SERVICE PLAN | 412 | $90K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE CO | 440 | $13K |
| Stop-loss / reinsurancereinsurance | STANDARD SECURITY LIFE | 244 | $214K |
| Other | CLAREMONT BEHAVIORAL SERVICES | 0 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 562 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.