| 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 | 1.65% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | — | $4K | $4K | 1.65% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | — | $2K | $2K | 1.65% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH MCLENNAN AGENCY LLC | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | — | $352 | $352 | 1.65% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INS CO EIN 59-1031071 THIRD-PARTY ADMINISTRATO | Other services; Participant communication; Direct payment from the plan; Claims processing; Non-monetary compensation; Recordkeeping and information management (computing, tabulating, data processing, etc.); Recordkeeping fees; Float revenue; Contract Administrator Service code 12 | — | $162K |
| WILLIS TOWERS WATSON EIN 26-0775680 HRA ADMINISTRATION | Other fees; Other services; Direct payment from the plan Service code 49 | — | $113K |
| KPMG LLP EIN 13-5565207 PLAN AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $87K |
| KAISER FOUNDATION HEALTH PLAN OF HI EIN 94-1340523 THIRD-PARTY ADMINISTRATO | Direct payment from the plan; Claims processing; Other services; Recordkeeping fees; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Participant communication Service code 12 | — | $71K |
| BLACKROCK FINANCIAL MANAGEMENT, INC EIN 13-3806691 INVESTMENT MANAGER | Investment management; Investment advisory (plan); Direct payment from the plan; Investment management fees paid directly by plan Service code 27 | — | $70K |
| THE NORTHERN TRUST COMPANY EIN 36-1561860 PLAN TRUSTEE | Float revenue; Direct payment from the plan; Trustee (bank, trust company, or similar financial institution); Other investment fees and expenses; Account maintenance fees; Trustee (directed); Other fees Service code 21 | — | $35K |
| GENERAL DYNAMICS INF TECHNOLOGY INC EIN 54-1194322 OBIEE COST ALLOCATION | Other services; Direct payment from the plan; Other fees Service code 49 | — | $23K |
| EY EIN 34-6565596 TAX FORM PREPARER | Direct payment from the plan; Consulting (general) Service code 16 | — | $21K |
| CROWE LLP EIN 35-0921680 FINANCIAL STATEMENT PREP | Direct payment from the plan; Accounting (including auditing); Consulting (general) Service code 10 | — | $13K |
| AON CONSULTING, INC. EIN 22-2232264 FORM 5500 PREP & ACTUARI | Consulting (general); Direct payment from the plan; Actuarial Service code 11 | — | $12K |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 TPA & PHARM BENEFIT MGR | Claims processing; Direct payment from the plan; Participant communication; Other services; Recordkeeping fees; Other fees; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $10K |
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 THIRD PARTY ADMINISTRATO | Float revenue; Other services 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 | 4,681 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,681 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(4 contracts) | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | 1,941 | $579K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,941 | — |
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.