| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | HARTFORD LIFE AND ACCIDENT | — | $108K | $108K | 1.28% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | ARAG INSURANCE COMPANY | $21K | — | $21K | 13.00% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | ACE AMERICAN INSURANCE COMPANY | — | $10K | $10K | 20.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 NONE | Claims processing; Other services; Direct payment from the plan Service code 12 | — | $2.4M |
| OPTUM HSA NONE | Contract Administrator; Direct payment from the plan Service code 13 | 11000 OPTUM CIRCLE EDEN PRAIRIE, MN 55344 | $2.2M |
| LIVONGO NONE | Contract Administrator; Direct payment from the plan Service code 13 | 150 W. EVELYN AVENUE SUITE 150 MOUNTAIN VIEW, CA 94041 | $824K |
| CVS CAREMARK EIN 05-0340626 NONE | Direct payment from the plan; Contract Administrator; Claims processing Service code 12 | — | $220K |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $204K |
| MDLIVE NONE | Direct payment from the plan; Contract Administrator Service code 13 | 3350 SW 148TH AVENUE SUITE 300 MIRAMAR, FL 33027 | $109K |
| UNITED BEHAVIORAL HEALTH DBA OPTUM EIN 94-2649097 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $48K |
| RUBIN BROWN LLP EIN 43-0765316 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $23K |
| BANK OF AMERICA EIN 94-1687665 NONE | Trustee (bank, trust company, or similar financial institution); Float revenue; Direct payment from the plan Service code 21 | — | $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 | 5,603 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 831 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 6,434 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | UNITEDHEALTHCARE INSURANCE COMPANY | 18 | $162K |
| Dental(2 contracts) | UNITEDHEALTHCARE INSURANCE COMPANY | 18 | $162K |
| Vision(4 contracts, 2 carriers) | EYEMED VISION CARE | 10,182 | $814K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 6,132 | $8.5M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 6,132 | $8.5M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 6,132 | $8.5M |
| Other(4 contracts, 4 carriers) | HARTFORD LIFE AND ACCIDENT | 6,132 | $8.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 10,182 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.