| 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 | $50K | — | $50K | 2.37% |
| 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 | $12K | $12K | 0.91% |
| 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 |
|---|---|---|---|
| EXPRESS SCRIPTS EIN 22-3461740 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $395K |
| BUSINESSOLVER.COM, INC. EIN 42-1503807 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $370K |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $193K |
| THE HARTFORD CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 1 GRIFFIN ROAD NORTH WINDSOR, CT 06095 | $116K |
| UNITED CONCORDIA COMPANIES, INC. EIN 25-1687586 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $108K |
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 | 2,933 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 871 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,804 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ACE AMERICAN INSURANCE COMPANY | 9,160 | $31K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1 | $3K |
| Vision | EYEMED | 5,269 | $525K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 7,833 | $2.1M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 2,936 | $1.3M |
| Stop-loss / reinsurancereinsurance | HM LIFE INCURANCE COMPANY | 2,708 | $225K |
| Other(4 contracts, 4 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 9,160 | $2.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 9,160 | — |
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.