| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | 75 STATE STREET, SUITE 1710 BOSTON, MA 021091807 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $89K | $89K | 0.49% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FIDELITY EIN 04-2647786 PARTY-IN-INTEREST | Other services Service code 49 | — | $2.6M |
| AETNA EIN 06-6033492 PARTY-IN-INTEREST | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Other services; Contract Administrator Service code 12 | — | $2.0M |
| ANTHEM INSURANCE EIN 35-0781558 PARTY-IN-INTEREST | Other services; Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $1.6M |
| CVS CAREMARK EIN 20-8404182 PARTY-IN-INTEREST | Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $315K |
| METROPOLITAN LIFE EIN 13-5581829 PARTY-IN-INTEREST | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing Service code 12 | — | $191K |
| MERCER EIN 13-2834414 PARTY-IN-INTEREST | Consulting (general) Service code 16 | — | $186K |
| OPTUM HEALTH (UBH) EIN 41-1591944 PARTY-IN INTEREST | Other services Service code 49 | — | $110K |
| HTA, LLC EIN 47-4919337 PARTY-IN-INTEREST | Consulting (general) Service code 16 | — | $103K |
| UNITED HEALTHCARE EIN 36-2739571 PARTY-IN-INTEREST | Claims processing; Other services; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $66K |
| ERNST & YOUNG EIN 34-6565596 PARTY-IN INTEREST | Consulting (general) Service code 16 | — | $60K |
| BUDCO EIN 38-1622051 PARTY- INTEREST | Other services Service code 49 | — | $41K |
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 | 19,659 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 116,299 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3,577 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 139,535 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(9 contracts, 9 carriers) | KAISER PERMANENTE - NO. CAL. | 184 | $4.4M |
| Vision | ANTHEM INSURANCE COMPANIES | 9,641 | $785K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 95,113 | $18.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 95,113 | — |
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.