| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | PO BOX 746600 ATLANTA, GA 30374 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $0 | $46K | $46K | 0.40% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | SUITE 1700 1 BEACON ST BOSTON, MA 02108 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $467K | $0 | $467K | 11.94% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $6K | $6K | 0.16% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE INSURANCE COMPANY EIN 36-2739571 CONTRACT ADMINISTRATOR | Claims processing; Other insurance fees and expenses Service code 12 | — | $12.0M |
| HORIZON HEALTHCARE SERVICES, INC. EIN 22-0999690 CONTRACT ADMINISTRATOR | Claims processing; Other insurance fees and expenses Service code 12 | — | $8.2M |
| DELTA DENTAL EIN 68-0652604 CONTRACT ADMINISTRATOR | Other insurance fees and expenses; Claims processing Service code 12 | — | $1.1M |
| WAGEWORKS EIN 94-3351864 CONTRACT ADMINISTRATOR | Claims processing; Other insurance fees and expenses Service code 12 | — | $281K |
| CIGNA HEALTH AND LIFE INS. CO. EIN 59-1031071 CONTRACT ADMINISTRATOR | Claims processing; Insurance brokerage commissions and fees Service code 12 | — | $20K |
| METROPOLITAN LIFE INSURANCE CO. EIN 13-5581829 CONTRACT ADMINISTRATOR | Claims processing; Insurance brokerage commissions and fees Service code 12 | — | $15K |
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 | 31,685 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 540 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 32,225 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA INC. | 145 | $416K |
| Vision | EYEMED VISION CARE | 62,072 | $4.7M |
| Life insurance(3 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 35,071 | $21.5M |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 36,981 | $2.5M |
| Long-term disability | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 31,685 | $11.5M |
| Other | NATIONAL UNION | 31,685 | $365K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 62,072 | — |
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.