| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST | 29982 NETWORK PLACE CHICAGO, IL 60673 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $11K | $11K | 0.86% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | 9811 KATY FREEWAY SUITE 500 HOUSTON, TX 77024 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $24K | $3K | $27K | 16.98% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 8285 TOURNAMENT DR SUITE 130 MEMPHIS, TN 38125 | BLUE CROSS BLUE SHIELD OF ARIZONA | $3K | — | $3K | 3.39% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | P.O. BOX 61187 VIRGINIA BEACH, VA 23466 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $5K | — | $5K | 9.38% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 29982 NETWORK PLACE CHICAGO, IL 60673 | BLUECROSS BLUESHIELD OF ILLINOIS | $4K | — | $4K | 7.99% |
| LOGAN DICKINSON3 | MALLICK TOWER 101 SUMMIT AVE STE 600 FORT WORTH, TX 76102 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 9.29% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST INC | PO BOX 61187 VIRGINIA BEACH, VA 23466 | UNITED HEALTHCARE INSURANCE COMPANY | $4K | — | $4K | 10.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | PO BOX 4557 NEW YORK, NY 10249 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $45 | $2K | 20.42% |
| WILLIS TOWERS WATSON US LLC3 | 500 N AKARD STREET STE 4300 DALLAS, TX 75201 | DEARBORN LIFE INSURANCE COMPANY | — | $68 | $68 | 2.45% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUM RX, INC. EIN 33-0441200 RX BENEFIT MANAGEMENT | Direct payment from the plan; Claims processing; Other fees; Float revenue Service code 12 | — | $984K |
| BCBST EIN 62-0427913 NONE | Contract Administrator Service code 13 | — | $766K |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $305K |
| BSWIFT EIN 36-4391310 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $183K |
| USI SOUTHWEST INC EIN 76-0206321 BROKER | Other commissions Service code 55 | — | $73K |
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 | 2,335 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 41 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 41 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,417 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH ALLIANCE MEDICAL PLANS | 101 | $727K |
| Dental(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF ILLINOIS | 101 | $63K |
| Vision(2 contracts, 2 carriers) | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 323 | $56K |
| Life insurance(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,335 | $1.4M |
| Long-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,335 | $1.3M |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ARIZONA | 13 | $94K |
| Stop-loss / reinsurancereinsurance | BERKLEY LIFE | 381 | $875K |
| Other(5 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,335 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,335 | — |
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."
No prospect flags tripped on this filing.