| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELEWARE INC. | COMMISSION LOCKBOX 28852 NEW YORK, NY 10087 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $154K | $154K | 2.46% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON US L | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $9K | $9K | 0.52% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELEWARE INC. | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $19K | $0 | $19K | 2.61% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH &BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $1K | $0 | $1K | 0.14% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON US L | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $2K | $2K | 0.93% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | 9900 BREN ROAD EAST MINNETONKA, MN 55343 | $3.1M |
| AETNA LIFE INSURANCE COMPAY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVENUE HARTFORD, CT 06156 | $590K |
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 CLAIMS ADMINISTRATOR | Direct payment from the plan Service code 50 | 900 COTTAGE GROVE LANE BLOOMFIELD, CT 06002 | $222K |
| DELTA DENTAL EIN 94-2761537 CLAIMS ADMINISTRATOR | Claims processing Service code 12 | 1515 W 22ND ST STE 450 OAK BROOK, IL 60523 | $140K |
| BEACON HEALTH OPTIONS, INC. EIN 54-1414194 INSURANCE CARRIER | Insurance services Service code 23 | 200 STATE STREET BOSTON, MA 02109 | $131K |
| CVS, CAREMARK EIN 05-0340626 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | 1 CVS DRIVE WOONSOCKET, RI 02895 | $110K |
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 | 9,466 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 9,466 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 126 | $2.7M |
| Dental(4 contracts, 3 carriers) | DELTA DENTAL | 856 | $840K |
| Vision | VISION SERVICE PLAN | 5,280 | $1.1M |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 14,892 | $6.2M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 9,466 | $264K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 9,466 | $1.7M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 14,892 | $6.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 14,892 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.