| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FREDERICK W. HOWARTH III3 Filed as: FREDERICK HOWARTH III | 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $80K | $0 | $80K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | PO BOX 28852 NEW YORK, NY 100878852 | METROPOLITAN LIFE INSURANCE COMPANY | — | $8K | $8K | 1.41% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE | PO BOX 28852 NEW YORK, NY 100878852 | METROPOLITAN LIFE INSURANCE COMPANY | — | $95 | $95 | 0.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON PENNSYLVANIA INS. | 300 S GRAND AVE STE 2000 PO BOX 8500 LOS ANGELES, CA 900713109 | METROPOLITAN LIFE INSURANCE COMPANY | — | $95 | $95 | 0.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITEDHEALTHCARE INSURANCE COMPANY EIN 36-2739571 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | — | $729K |
| EXPRESS SCRIPTS EIN 43-1420563 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $101K |
| MEDICAL MUTUAL OF OHIO EIN 34-0648820 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $97K |
| HEALTH ADVOCATE, INC. EIN 23-3080019 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $19K |
| INFINISOURCE EIN 38-2976613 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $12K |
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 | 1,325 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 19 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,344 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 300 | $934K |
| Dental | AETNA LIFE INSURANCE COMPANY | 1,816 | $1.2M |
| Vision | VISION SERVICE PLAN | 765 | $162K |
| Life insurance(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 1,825 | $1.5M |
| Long-term disability(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 1,325 | $1.7M |
| Other(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 1,825 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,825 | — |
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.