| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 | P.O. BOX 28852 LOCKBOX 28852 NEW YORK, NY 10087 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $23K | — | $23K | 1.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 400 MIDLAND DRIVE SUITE 300 MT. LAUREL, NJ 08054 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $12K | — | $12K | 0.55% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE, INC. | P.O. BOX 28852 LOCKBOX 28852 NEW YORK, NY 10087 | HARTFORD LIFE AND ACCIDENT | $0 | $11K | $11K | 0.83% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2 PIERCE PLACE 21ST FLOOR ITASCA, IL 60143 | HARTFORD LIFE AND ACCIDENT | $0 | $10K | $10K | 0.74% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE, INC. | P.O. BOX 28852 LOCKBOX 28852 NEW YORK, NY 10087 | CIGNA HEALTH & LIFE INSURANCE COMPANY | $6K | — | $6K | 8.13% |
| AON CONSULTING INC3 Filed as: AON | ONE LIBERTY PLAZA 165 BROADWAY, SUITE 3201 NEW YORK, NY 10006 | ACE AMERICAN INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HIGHMARK INC. EIN 23-1294723 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $1.4M |
| EXPRESS SCRIPTS EIN 22-3461740 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $476K |
| BUSINESSOLVER.COM, INC. EIN 42-1503807 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $389K |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $233K |
| THE HARTFORD CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 1 GRIFFIN ROAD NORTH WINDSOR, CT 06095 | $129K |
| UNITED CONCORDIA COMPANIES, INC. EIN 25-1687586 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $109K |
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 | 3,094 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,441 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,536 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | HIGHMARK INC. | 11,503 | $519K |
| Dental | CIGNA HEALTH & LIFE INSURANCE COMPANY | 3 | $75K |
| Vision(2 contracts, 2 carriers) | EYEMED | 6,321 | $657K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 6,327 | $2.2M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 3,390 | $1.3M |
| Stop-loss / reinsurancereinsurance | HM LIFE INCURANCE COMPANY | 3,156 | $180K |
| Other(4 contracts, 4 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 11,503 | $2.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 11,503 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.