| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVS LLC | — | HARTFORD LIFE AND ACCIDENT | $33K | $49K | $82K | 1.64% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ALIGHT SOLUTIONS LLC EIN 82-1061233 RECORD KEEPING | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $711K |
| HEALTH CARE SERVICE CORP EIN 36-1236610 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $305K |
| WILLIS TOWERS WATSON US LLC EIN 53-0181291 ACTUARY | Actuarial Service code 11 | — | $285K |
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $247K |
| THE NORTHERN TRUST COMPANY EIN 36-1561860 TRUSTEE/CUSTODIAN | Custodial (securities); Soft dollars commissions; Investment management fees paid directly by plan; Trustee (bank, trust company, or similar financial institution); Float revenue Service code 19 | — | $91K |
| KENNEDY CAPITAL MANAGEMENT INC. EIN 43-1225960 INVESTMENT MANAGER | Investment management fees paid directly by plan; Soft dollars commissions; Investment management fees paid indirectly by plan; Investment management Service code 28 | — | $71K |
| BLACKROCK INSTITUTIONAL TRUST CO EIN 94-3112180 INVESTMENT MANAGER | Investment management fees paid directly by plan; Investment management; Trustee (bank, trust company, or similar financial institution); Trustee (discretionary); Direct payment from the plan Service code 21 | — | $56K |
| ACADIAN ASSET MANAGEMENT, LLC EIN 04-2929221 INVESTMENT MANAGER | Investment management fees paid directly by plan; Investment management Service code 28 | — | $42K |
| OPTUMRX EIN 11-2581812 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $30K |
| MITCHELL & TITUS, LLP EIN 13-2781641 AUDITOR | Accounting (including auditing) Service code 10 | — | $28K |
| NORTHWEST PLAN SERVICES INC EIN 91-2090931 CONSULTING | Consulting fees; Consulting (general) Service code 16 | — | $19K |
| EXELON BUSINESS SERVICES COMPANY EIN 23-3063219 ADMINISTRATOR | Plan Administrator Service code 14 | — | $19K |
| DEPT OF HEALTH AND HUMAN SERVICES EIN 52-0883104 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $13K |
| HARDING LOEVENER LP EIN 27-0684167 INVESTMENT MANAGER | Investment management fees paid directly by plan; Soft dollars commissions; Investment management Service code 28 | — | $9K |
| ARIEL INVESTMENTS LLC EIN 02-0712418 INVESTMENT MANAGER | Investment management; Soft dollars commissions; Investment management fees paid directly by plan Service code 28 | — | $6K |
| PHARMACEUTICAL STRATEGY GROUP EIN 20-2422296 CONSULTING | Consulting (general); Consulting fees Service code 16 | — | $6K |
| CREEKSIDE EIN 36-3587072 PRINTER | Participant communication Service code 38 | — | $6K |
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 | 4,754 | Continuation coverage (COBRA, retiree health). |
| Beneficiaries receiving benefits | 745 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 4,754 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | HARTFORD LIFE AND ACCIDENT | 4,661 | $5.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,661 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.