| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFIT | 21300 VICTORY BLVD STE 635 WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $118K | $118K | 1.91% |
| KENNETH W HEAD3 | 880 S PLEASANTBURG DR STE 2C GREENVILLE, SC 296072450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $23K | — | $23K | 3.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 NONE | Claims processing; Direct payment from the plan; Other services Service code 12 | — | $7.4M |
| XEROX CORP EIN 16-0468020 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $3.0M |
| HEALTH FITNESS CORPORATION EIN 41-1580506 NONE | Direct payment from the plan; Other services Service code 49 | — | $1.1M |
| EXPRESS SCRIPTS INC. EIN 43-1420563 NONE | Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $771K |
| TOWERS WATSON DELAWARE INC. EIN 53-0181291 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $266K |
| PARTNERCOMM INC. EIN 75-2540310 NONE | Copying and duplicating; Direct payment from the plan Service code 36 | — | $249K |
| ERNST & YOUNG EIN 34-6565596 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $96K |
| TELEDOC INC. NONE | Direct payment from the plan; Other services Service code 49 | 1945 LAKEPOINTE DRIVE LEWISVILLE, TX 75057 | $93K |
| COCKRELL ENOVATION EIN 75-1183045 NONE | Copying and duplicating; Direct payment from the plan Service code 36 | — | $84K |
| HEALTHY ALLIANCE LIFE INSURANCE CO EIN 86-0257201 NONE | Float revenue; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other services; Claims processing Service code 12 | — | $40K |
| WALKER TRACKER, LLC EIN 20-8355826 NONE | Direct payment from the plan; Other services Service code 49 | — | $9K |
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 | 18,532 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,929 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 20,461 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 607 | $3.1M |
| Dental | RELIANCE STANDARD LIFE INSURANCE COMPANY | 4,435 | $778K |
| Vision | VISION SERVICE PLAN | 7,772 | $1.3M |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 13,944 | $6.3M |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 22,573 | $8.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 22,573 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.