| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE, INC. | PO BOX 28852 NEW YORK, NY 10087 | KAISER FOUNDATION HEALTH PLAN INC. | $33K | — | $33K | 2.51% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | COMMISION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | AETNA LIFE INSURANCE CO. | $75K | — | $75K | 9.36% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE, INC. | PO BOX 28852 NEW YORK, NY 10087 | KAISER FOUNDATION HEALTH PLAN INC. | $17K | — | $17K | 2.62% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES CENTRAL, INC. | 75 REMITTANCE DRIVE SUITE 1446 LOCKBOX 1446 CHICAGO, IL 606751446 | MINNESOTA LIFE INSURANCE COMPANY | $9K | — | $9K | 2.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | PO BOX 28852 NEW YORK, NY 10087 | UNITEDHEALTHCARE INSURANCE COMPANY | $31K | — | $31K | 9.34% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | PO BOX 28852 NEW YORK, NY 100878852 | VISION SERVICE PLAN | $28K | — | $28K | 10.00% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | CNG TOWER, FLOOR 10 PITTSBURGH, PA 15222 | ZURICH AMERICAN INSURANCE COMPANY | $16K | — | $16K | 15.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | PO BOX 28852 NEW YORK, NY 100878852 | COMBINED INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 7.30% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | PO BOX 28852 NEW YORK, NY 100878852 | COMBINED LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 7.32% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HIGHMARK EIN 23-1294723 NONE | Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | — | $888K |
| TOWERS WATSON EIN 23-1159360 NONE | Actuarial; Direct payment from the plan; Consulting (pension) Service code 11 | — | $685K |
| AETNA EIN 06-6033492 NONE | Direct payment from the plan; Claims processing; Contract Administrator Service code 12 | — | $371K |
| AMERICAN BENEFITS AND COMPENSATION EIN 13-3556882 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $168K |
| UNITED HEALTHCARE EIN 36-3377945 NONE | Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $115K |
| CIGNA NONE | Direct payment from the plan; Insurance services Service code 23 | PO BOX 15964 WILMINGTON, DE 19580 | $90K |
| WAGEWORKS NONE | Other services; Direct payment from the plan Service code 49 | 1100 PARK PLACE 4TH FLOOR SAN MATEO, CA 94403 | $74K |
| LIBERTY MUTUAL EIN 04-6076039 NONE | Direct payment from the plan; Claims processing; Contract Administrator Service code 12 | — | $63K |
| ARAG NONE | Insurance services; Direct payment from the plan Service code 23 | 400 LOCUST STREET SUITE 480 DES MOINES, IA 50309 | $31K |
| REDBRICK HEALTH NONE | Direct payment from the plan; Contract Administrator Service code 13 | 510 MARQUETTE AVENUE SUITE 500 MINNEAPOLIS, MN 55402 | $30K |
| DELTA DENTAL INSURANCE COMPANY NONE | Direct payment from the plan; Insurance services Service code 23 | PO BOX 1809 ALPHARETTA, GA 300231809 | $24K |
| CAREMARK EIN 05-0479173 NONE | Direct payment from the plan; Contract Administrator; Claims processing Service code 12 | — | $23K |
| PNC BANK, N.A. NONE | Other services; Direct payment from the plan Service code 49 | 249 5TH AVE., STE. 30 PITTSBURGH, PA 15222 | $20K |
| SCHNEIDER DOWNS EIN 25-1408703 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $12K |
| METLIFE DENTAL NONE | Direct payment from the plan; Insurance services Service code 23 | PO BOX 981987 EL PASO, TX 79998 | $10K |
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 | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 622 | $4.0M |
| Dental | SIMNSA | 622 | $1.2M |
| Vision(5 contracts, 5 carriers) | AETNA LIFE INSURANCE CO. | 3,794 | $1.6M |
| Life insurance | MINNESOTA LIFE INSURANCE COMPANY | 5,494 | $468K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 2,086 | $502K |
| Other | ZURICH AMERICAN INSURANCE COMPANY | 3,031 | $105K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,494 | — |
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.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.