| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENESYS ADMINISTRATORS EIN 38-2383171 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $679K |
| COLUMBIA MANAGEMENT INVESTMENT ADVI EIN 41-1533211 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $362K |
| DELTA DENTAL EIN 94-1461312 NONE | Direct payment from the plan; Plan Administrator Service code 14 | — | $280K |
| ANTHEM BLUE CROSS EIN 95-3760980 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $179K |
| RX EDO NONE | Direct payment from the plan; Claims processing Service code 12 | 7800 DALLAS PKWY PLANO, TX 75093 | $152K |
| KAUFMANN & GOBLE EIN 94-2614826 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $120K |
| EIDE BAILLY LLP EIN 45-0250958 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $103K |
| NWQ INVESTMENTS EIN 47-0875103 NONE | Direct payment from the plan; Investment management Service code 28 | — | $94K |
| AMERICAN HEALTH HOLDING NONE | Other services; Direct payment from the plan Service code 49 | 7400 W CAMPUS RD F-510 NEW ALBANY, OH 43054 | $86K |
| NANCY FERGUSON EIN 94-6401544 NONE | Employee (plan) Service code 30 | — | $81K |
| KRAW LAW GROUP EIN 77-0171216 NONE | Legal; Direct payment from the plan Service code 29 | — | $80K |
| RAYMOND JAMES NONE | Investment management; Direct payment from the plan Service code 28 | 150 AMADEN BLVD, SUITE 1375 SAN JOSE, CA 95113 | $56K |
| BEAT IT PROGRAM EIN 77-0111619 NONE | Other services; Direct payment from the plan Service code 49 | — | $55K |
| MATRIX TRUST COMPANY EIN 75-3182674 NONE | Investment management fees paid indirectly by plan; Custodial (securities); Investment management; Direct payment from the plan Service code 19 | — | $46K |
| EVOLUTION BENEFITS EIN 06-1593514 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $34K |
| CRYSTAL CLEAR RX NONE | Other services; Direct payment from the plan Service code 49 | 19753 PIKES PEAK CT G-103 PARKER, CO 80138 | $18K |
| PART D ADVISORS, INC. NONE | Other services; Direct payment from the plan Service code 49 | 17199 NORTH LAUREL PARK DRIVE, 400 LIVONIA, MI 48152 | $18K |
| SALTZMAN & JOHNSON LAW CORP NONE | Legal; Direct payment from the plan Service code 29 | 1141 HARBOR BAY PKAY ALAMEDA, CA 94502 | $18K |
| KEN STUART NONE | Direct payment from the plan; Consulting (general) Service code 16 | SAN DIEGO SAN DIEGO, CA 92108 | $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 | 2,125 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 585 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,710 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 2,697 | $244K |
| Life insurance | HCC LIFE INSURANCE COMPANY | 800 | $94K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,643 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Filing reports zero broker compensation on a plan over 100 participants. Likely direct-write or unreported — worth a knock.