| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC0 | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | FOUR EVER LIFE INS CO. | $4K | $475 | $4K | 4.50% |
| ANTHEM INSURANCE COMPANIES, INC.0 | 120 MONUMENT CIRCLE INDIANAPOLIS, IN 462044903 | FOUR EVER LIFE INS CO. | $4K | $475 | $4K | 4.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITEDHEALTHCARE INSURANCE COMPANY EIN 36-2739571 CONTRACTOR | Contract Administrator; Direct payment from the plan; Claims processing Service code 12 | — | $2.4M |
| ALIGHT BENEFITS ADMINISTRATOR | Direct payment from the plan; Claims processing; Contract Administrator Service code 12 | 100 HALF DAY ROAD LINCOLNSHIRE, IL 60069 | $437K |
| CONSUMER VALUE STORE EIN 05-0340606 CONTRACTOR | Direct payment from the plan; Contract Administrator Service code 13 | — | $368K |
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 CONTRACTOR | Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $113K |
| DELTA DENTAL OF CALIFORNIA EIN 94-1461312 CONTRACTOR | Contract Administrator; Direct payment from the plan Service code 13 | — | $101K |
| WAGEWORKS EIN 20-0198855 CONTRACTOR | Contract Administrator; Direct payment from the plan Service code 13 | — | $76K |
| VISION SERVICE PLAN EIN 94-1632821 CONTRACTOR | Direct payment from the plan; Contract Administrator Service code 13 | — | $59K |
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 | 4,570 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 456 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,026 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | FOUR EVER LIFE INS CO. | 16 | $95K |
| Dental(2 contracts) | DELTA DENTAL OF NEW YORK | 3,750 | $290K |
| Vision | VISION SERVICE PLAN | 4,348 | $789K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,348 | — |
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.