| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES | 353 NORTH CLARK STREET CHICAGO, IL 60654 | PRINCIPAL LIFE INSURANCE COMPANY | — | -$35K | -$35K | -1.26% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE, INC. | PO BOX 28852 NEW YORK, NY 10087 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 5.14% |
| WILLIS TOWERS WATSON US LLC Filed as: TOWERS WATSON DELAWARE IN | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | $0 | $8K | 20.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM INSURANCE COMPANIES, INC. EIN 35-0781558 NONE | Claims processing; Float revenue; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 12 | — | $4.1M |
| LIFEWORKS US INC. EIN 81-1114266 NONE | Claims processing Service code 12 | 3311 E. OLD SHAKOPEE ROAD MINNEAPOLIS, MN 55425 | $149K |
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 | 12,635 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 25 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 9 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 12,669 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF INDIANA | 13,904 | $3.8M |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 12,316 | $468K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 11,981 | $2.8M |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 515 | $61K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 11,981 | $2.8M |
| Stop-loss / reinsurancereinsurance | ANTHEM INSURANCE COMPANIES, INC. | 12,635 | $1.0M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 914 | $40K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 13,904 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.