| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| UNIVERSAL BENEFIT SOLUTIONS3 | UNIVERSAL BENEFIT SOLUTIONS 138 WASHAM RD MOORESVILLE, NC 28117 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON LTD | $80K | $86K | $166K | 3.82% |
| ROBERT BRICKWEG3 | ROBERT BRICKWEG 138 WASHAM RD MOORESVILLE, NC 28117 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $300K | $0 | $300K | 9.83% |
| HATTERAS3 | 56 PARK ROAD TINTON FALLS, NJ 07724 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $12K | $12K | 0.40% |
| HARVARD PRINTING GROUP3 | HARVARD PRINTING GROUP 175 US HIGHWAY 46 WEST FAIRFIELD, NJ 07004 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $4K | $4K | 0.12% |
| AON CONSULTING INC3 Filed as: HEWITT ASSOCIATES, LLC | 39340 TREASURY CENTER CHICAGO, IL 60694 | KAISER PERMANENTE | $211K | $0 | $211K | 9.85% |
| AON CONSULTING INC3 Filed as: HEWITT ASSOCIATES | 39340 TREASURY CENTER CHICAGO, IL 60694 | AETNA LIFE INSURANCE COMPANY | $10K | $0 | $10K | 1.00% |
| AON CONSULTING INC3 Filed as: HEWITT ASSOCIATES LLC | 100 HALF DAY RD LINCONDSHIRE, IL 60069 | HEALTHSPAN INTERGRATED CARE | $9K | $0 | $9K | 0.83% |
| AON CONSULTING INC3 Filed as: HEWITT ASSOCIATES, LLC | 100 HALF DAY RD 40B-4N-3 LINCOLNSHIRE, IL 60069 | KAISER FOUNDATION HEALTH PLAN, NORTHWEST | $9K | $0 | $9K | 0.92% |
| AON CONSULTING INC3 Filed as: HEWITT ASSOCIATES, LLC | 39340 TREASURY CENTER CHICAGO, IL 60694 | KAISER FOUNDATION HEALTH PLAN OF GEOGIA INC | $9K | $0 | $9K | 0.99% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | P.O. BOX 905494 CHARLOTTE, NC 28290 | MCS LIFE INSURANCE COMPANY | $30K | $0 | $30K | 5.00% |
| UNIVERSAL BENEFIT SOLUTIONS3 | 138 WASHAM ROAD MOORESVILLE, NC 28117 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON STD | $0 | $462 | $462 | 0.10% |
| AON CONSULTING INC3 Filed as: HEWITT ASSOCIATES, LLC | 39340 TREASURY CENTER CHICAGO, IL 60694 | KAISER PERMANENTE | $4K | $0 | $4K | 1.00% |
| AON CONSULTING INC3 Filed as: HEWITT INS BROKERAGE | PO BOX 39030 CHICAGO, IL 60694 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES | $4K | $0 | $4K | 1.00% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | P. O. BOX 905494 CHARLOTTE, NC 28290 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $4K | $0 | $4K | 1.24% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | P. O. BOX 905494 CHARLOTTE, NC 28290 | TRIPLE-S VIDA, INC | $3K | $0 | $3K | 13.00% |
| MULLIN TBG INSURANCE AGENCY SVCS3 Filed as: MULLIN TBG INSURANCE AGENCY | MULLIN TBG INSURANCE AGENCY 540 LAKE COOK RD STE 150 DEERFIELD, IL 60015 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 20.50% |
| M FINANCIAL HOLDINGS INC3 | M FINANCIAL HOLDINGS INC 1125 NW COUCH ST STE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $168 | $168 | 1.61% |
| MULLIN TBG INSURANCE AGENCY SVCS3 | MULLIN TBG INSURANCE AGENCY SVCS 540 LAKE COOK RD STE 150 DEERFIELD, IL 60015 | THE PAUL REVER LIFE INSURANCE COMPAY | $248 | $58 | $306 | 3.65% |
| SUMMA FINANCIAL CORP3 Filed as: SUMMA FINANCIAL CORPORATION | SUMMA FINANCIAL CORPORATION 520 LAKE COOK RD STE 520 DEERFIELD, IL 60015 | THE PAUL REVER LIFE INSURANCE COMPAY | $46 | $0 | $46 | 0.55% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE CO. EIN 06-6033492 NONE | Contract Administrator Service code 13 | 7400 WEST CAMPUS ROAD NEW ALBANY, OH 43054 | $12.7M |
| MCS LIFE INSURANCE INC EIN 66-0520918 NONE | Contract Administrator; Claims processing Service code 12 | 255 AVE PONCE DE LEON STE 105 SAN JUAN, PR 00917 | $597K |
| HEWITT ASSOCIATES, LLC EIN 36-2235791 NONE | Actuarial Service code 11 | 100 HALF DAY ROAD LINCOLNSHIRE, IL 60069 | $437K |
| FIDELITY INVESTMENTS EIN 04-2647786 NONE | Investment advisory (plan) Service code 27 | PO BOX 73307 CHICAGO, IL 606737307 | $180K |
| HDMS EIN 52-2182411 NONE | Recordkeeping fees Service code 64 | 123 N. WACKER DR. STE. 650 CHICAGO, IL 60606 | $124K |
| ADP NATIONAL ACCOUNTS EIN 22-1467904 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 2835 W. DECKER LAKE DRIVE HERRIMAN, UT 84119 | $119K |
| WELLNESS COACHES USA EIN 32-0025442 NONE | Employee (plan) Service code 30 | 725 SKIPPACK PIKE, STE. 300 BLUEBELL, PA 19422 | $73K |
| ALLSUP EIN 37-1170934 | Employee (plan) Service code 30 | 300 ALLSUP PLACE BELLEVILLE, IL 62223 | $24K |
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 | 37,024 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 37,024 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(9 contracts, 8 carriers) | KAISER PERMANENTE | 4,081 | $6.0M |
| Dental(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 3,487 | $1.1M |
| Vision(6 contracts, 4 carriers) | KAISER PERMANENTE | 38,178 | $6.4M |
| Life insurance(4 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 29,476 | $8.3M |
| Short-term disability(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 9 | $19K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON LTD | 24,505 | $4.4M |
| Prescription drug(4 contracts, 3 carriers) | KAISER PERMANENTE | 589 | $4.4M |
| Other(5 contracts, 5 carriers) | AETNA LIFE INSURANCE COMPANY | 25,497 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 38,178 | — |
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.