| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 | 38 EASTWOOD DRIVE SUITE 300 SOUTH BURLINGTON, VT 05403 | KAISER FOUNDATION HEALTH PLAN INC. REGION HI | $940 | — | $940 | 0.74% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CONNECTICUT GENERAL LIFE INS CO EIN 59-1031071 NONE | Non-monetary compensation; Claims processing; Contract Administrator; Named fiduciary; Float revenue; Participant communication; Other services; Direct payment from the plan Service code 12 | — | $5.6M |
| OPTUM RX EIN 33-0441200 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $4.4M |
| PRUDENTIAL INSURANCE CO OF AMERICA EIN 22-1211670 EMPLOYER | Other investment fees and expenses; Investment advisory (plan); Investment management; Investment management fees paid directly by plan; Direct payment from the plan; Contract Administrator Service code 13 | — | $1.0M |
| WEBTPA EIN 75-2611444 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $599K |
| UNITEDHEALTHCARE INSURANCE COMPANY EIN 36-2739571 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $300K |
| PRUDENTIAL TRUST COMPANY EIN 52-1679020 TRUSTEE/ AFFILIATED | Direct payment from the plan; Investment management fees paid directly by plan; Other investment fees and expenses; Investment management Service code 28 | — | $18K |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 NONE | Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $18K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 18,407 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 18,407 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(19 contracts, 15 carriers) | AETNA HEALTH INC. | 635 | $8.5M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 7,619 | $2.4M |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 27,650 | $4.1M |
| Life insurance(3 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,119 | $13.4M |
| Prescription drug(2 contracts, 2 carriers) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION, INC. | 56 | $353K |
| Other | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 7,619 | $2.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 27,650 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.