| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | — | $4K | $4K | 1.78% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | — | $4K | $4K | 1.78% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | — | $2K | $2K | 1.78% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH MCLENNAN AGENCY LLC | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | — | $436 | $436 | 1.78% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INS CO EIN 59-1031071 THIRD-PARTY ADMINISTRATO | Contract Administrator; Direct payment from the plan; Float revenue; Other services; Non-monetary compensation; Recordkeeping and information management (computing, tabulating, data processing, etc.); Participant communication; Claims processing; Recordkeeping fees Service code 12 | — | $132K |
| WILLIS TOWERS WATSON EIN 26-0775680 HRA ADMINISTRATION | Other services; Other fees; Direct payment from the plan Service code 49 | — | $114K |
| BLACKROCK FINANCIAL MANAGEMENT, INC EIN 13-3806691 INVESTMENT MANAGER | Direct payment from the plan; Investment advisory (plan); Investment management; Investment management fees paid directly by plan Service code 27 | — | $92K |
| KPMG LLP EIN 13-5565207 PLAN AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $83K |
| KAISER FOUNDATION HEALTH PLAN OF HI EIN 94-1340523 THIRD-PARTY ADMINISTRATO | Claims processing; Direct payment from the plan; Other services; Recordkeeping fees; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Participant communication Service code 12 | — | $83K |
| THE NORTHERN TRUST COMPANY EIN 36-1561860 TRUSTEE, INV ADV & MGMT | Trustee (directed); Float revenue; Account maintenance fees; Direct payment from the plan; Trustee (bank, trust company, or similar financial institution); Investment management fees paid directly by plan; Investment advisory (plan); Investment management; Other fees; Other investment fees and expenses Service code 21 | — | $53K |
| ANTHEM HEALTH PLANS OF VIRGINIA, IN EIN 54-0357120 THIRD-PARTY ADMINISTRATO | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Direct payment from the plan; Claims processing; Float revenue; Other services Service code 12 | — | $52K |
| EY EIN 34-6565596 TAX FORM PREPARER | Direct payment from the plan; Consulting (general) Service code 16 | — | $32K |
| BNY MELLON EIN 13-5160382 INVESTMENT MANAGER | Investment management fees paid directly by plan; Investment management; Direct payment from the plan Service code 28 | — | $20K |
| PRIME THERAPEUTICS LLC EIN 26-0076803 PHARMACY BENEFIT MANAGER | Participant communication; Other services; Claims processing; Contract Administrator; Recordkeeping fees; Direct payment from the plan; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $14K |
| CROWE LLP EIN 35-0921680 FINANCIAL STATEMENT PREP | Direct payment from the plan; Accounting (including auditing); Consulting (general) Service code 10 | — | $12K |
| AON CONSULTING, INC. EIN 22-2232264 FORM 5500 PREPARER | Direct payment from the plan; Consulting (general) Service code 16 | — | $6K |
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 THIRD PARTY ADMINISTRATO | Other services; Float revenue Service code 49 | — | $0 |
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 | 4,635 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,635 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(4 contracts) | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | 1,829 | $567K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,829 | — |
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."
No prospect flags tripped on this filing.