| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEWITT INSURANCE BROKERAGE LLC3 Filed as: HEWITT INSURANCE AGENCY | 39340 TREASURY CENTER CHICAGO, IL 606949300 | HEALTHAMERICA OF PENNSYLVANIA, INC. HMO | $48K | — | $48K | 1.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS OF TX | 818 TOWN AND COUNTRY SUITE 500 HOUSTON, TX 77024 | MINNESOTA LIFE INSURANCE COMPANY | $49K | — | $49K | 1.26% |
| HEWITT INSURANCE BROKERAGE LLC3 | 39030 TREASURY CENTER CHICAGO, IL 606949000 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG., INC. | $28K | — | $28K | 1.00% |
| HEWITT INSURANCE BROKERAGE LLC3 Filed as: HEWITT INSURANCE BROKERAGE | 39030 TREASURY CENTER CHICAGO, IL 606949000 | HEALTH NEW ENGLAND, INC. | $22K | — | $22K | 0.99% |
| HEWITT INSURANCE BROKERAGE LLC3 | 39030 TREASURY CTR CHICAGO, IL 606949000 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $4K | $4K | 1.10% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS OF TX | 818 TOWN AND COUNTRY SUITE 500 HOUSTON, TX 77024 | MINNESOTA LIFE INSURANCE COMPANY | $28K | — | $28K | 10.00% |
| AON CONSULTING INC3 Filed as: HEWITT ASSOCIATES LLC | 4 OVERLOOK POINT LINCOLNSHIRE, IL 60069 | HEALTHSPAN INTEGRATED CARE | $2K | — | $2K | 1.00% |
| HEWITT INSURANCE BROKERAGE LLC3 Filed as: HEWITT INSURANCE BROKERAGE | 100 HALF DAY ROAD LINCOLNSHIRE, IL 60069 | KEYSTONE HEALTH PLAN CENTRAL | $4K | — | $4K | 2.35% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM INSURANCE COMPANIES INC EIN 35-0781558 NONE | Float revenue; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing Service code 12 | — | $3.5M |
| VALUE OPTIONS EIN 54-1414194 NONE | Insurance services; Direct payment from the plan Service code 23 | — | $156K |
| PORTER WRIGHT MORRIS AND ARTHUR EIN 31-4373657 NONE | Legal; Direct payment from the plan Service code 29 | — | $48K |
| DELOITTE EIN 13-3891517 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $47K |
| LCG ASSOCIATES INC EIN 75-1680350 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $25K |
| NORTHERN TRUST COMPANY EIN 36-1561860 TRUSTEE | Direct payment from the plan; Investment management; Investment management fees paid directly by plan; Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $19K |
| LEGACY PROFESSIONALS EIN 32-0043599 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $19K |
| CONNECTICUT GENERAL LIFE INSURANCE EIN 06-0303370 NONE | Named fiduciary; Contract Administrator; Direct payment from the plan; Float revenue; Non-monetary compensation; Claims processing; Participant communication; Other services Service code 12 | — | $0 |
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 | 7,578 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4,497 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 18 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 12,093 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(8 contracts, 8 carriers) | HEALTHAMERICA OF PENNSYLVANIA, INC. HMO | 665 | $10.8M |
| Life insurance(3 contracts) | MINNESOTA LIFE INSURANCE COMPANY | 15,372 | $7.0M |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 0 | $2K |
| Prescription drug(2 contracts, 2 carriers) | HEALTH NEW ENGLAND, INC. | 177 | $2.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 15,372 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.