| 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 | — | $83K | $83K | 0.46% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FIDELITY EIN 04-2647786 PARTY-IN-INTEREST | Contract Administrator; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 13 | — | $2.8M |
| AETNA EIN 06-6033492 PARTY-IN-INTEREST | Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 12 | — | $1.7M |
| ANTHEM INSURANCE EIN 35-0781558 PARTY-IN-INTEREST | Other services; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | — | $1.3M |
| CVS CAREMARK EIN 20-8404182 PARTY-IN-INTEREST | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | — | $263K |
| METROPOLITAN LIFE EIN 13-5581829 PARTY-IN-INTEREST | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator Service code 12 | — | $141K |
| ERNST & YOUNG EIN 34-6565596 PARTY-IN INTEREST | Consulting (general) Service code 16 | — | $48K |
| BUDCO EIN 38-1622051 PARTY- INTEREST | Other services Service code 49 | — | $48K |
| HTA, LLC EIN 47-4919337 PARTY-IN-INTEREST | Consulting (general) Service code 16 | — | $7K |
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 | 13,523 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 105,109 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3,240 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 121,872 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(9 contracts, 9 carriers) | KAISER PERMANENTE - NO. CAL. | 138 | $2.8M |
| Vision | ANTHEM INSURANCE COMPANIES | 7,196 | $548K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 87,852 | $18.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 87,852 | — |
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.