| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST | PO BOX 905601 CHARLOTTE, NC 28290 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $12K | $12K | 0.87% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | ONE WORLD FINANCIAL CENTER 200 LIBERTY ST NEW YORK, NY 10281 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $40 | $1K | 0.08% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE, INC. | 8285 TOURNAMENT DRIVE SUITE 130 MEMPHIS, TN 38125 | HCC LIFE INSURANCE COMPANY | — | $11K | $11K | 1.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 8285 TOURNAMENT DRIVE SUITE 130 MEMPHIS, TN 38125 | HCC LIFE INSURANCE COMPANY | — | $11K | $11K | 0.98% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 8285 TOURNAMENT DRIVE STE 130 MEMPHIS, TN 38125 | BLUE CROSS BLUE SHIELD OF ARIZONA | $2K | — | $2K | 3.37% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CORESOURCE, INC. EIN 35-1846036 NONE | Direct payment from the plan; Other services; Claims processing; Plan Administrator Service code 12 | — | $727K |
| AETNA LIFE INSURANCE CO. EIN 06-6033492 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $281K |
| HUMANA INSURANCE COMPANY EIN 39-1263473 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $167K |
| BSWIFT EIN 36-4391310 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $164K |
| MULTIPLAN EIN 43-6004435 NONE | Claims processing; Plan Administrator; Other services; Direct payment from the plan Service code 12 | — | $57K |
| ACCLAIM, INC. EIN 72-1356116 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $23K |
| DENTEMAX EIN 38-2612296 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $12K |
| ACS-A XEROX COMPANY EIN 36-4129784 NONE | Other services; Claims processing; Direct payment from the plan Service code 12 | — | $5K |
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 | 2,105 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 60 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,181 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH ALLIANCE MEDICAL PLANS | 105 | $672K |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF PENNSYLVANIA | 125 | $96K |
| Vision | VISION SERVICE PLAN | 85 | $5K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,105 | $1.4M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,105 | $1.3M |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 11 | $60K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | HCC LIFE INSURANCE COMPANY | 1,728 | $1.2M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,105 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,105 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.