| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC Filed as: PACIFIC RESOURCES BENEFIT | 21300 VICTORY BLVD, STE 635 WOODLAWN HIILS, CA 91367 | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $107 | $107 | 0.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BCBS - HEALTH CARE SERVICE CORP EIN 36-1236610 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $6.6M |
| XEROX HR SOLUTIONS, LLP EIN 16-0468020 ADMINISTRATION | Plan Administrator Service code 14 | — | $1.8M |
| CAREMARK LLC EIN 95-3382344 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $259K |
| SEYFARTH SHAW LLP EIN 36-2152202 LEGAL | Legal Service code 29 | — | $207K |
| WAGEWORKS INC. EIN 94-3351864 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $191K |
| TOWERS WATSON PENNSYLVANIA INC. EIN 23-1159360 ADMINISTRATION | Plan Administrator Service code 14 | — | $103K |
| HEWITT ASSOCIATES LLC EIN 36-2235791 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $69K |
| LAKE COUNTY PRESS EIN 36-4333650 CONSULTING | Consulting (general) Service code 16 | — | $6K |
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 | 23,684 | 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) | 23,684 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF ILLINOIS - HEALTH CARE SERVICE CORPORATION | 26,056 | $136.1M |
| Dental(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF ILLINOIS - HEALTH CARE SERVICE CORPORATION | 26,056 | $137.3M |
| Life insurance(3 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 49,888 | $7.5M |
| Long-term disability | LIBERTY MUTUAL ASSURANCE COMPANY OF BOSTON | 13,003 | $4.9M |
| Prescription drug | BLUE CARE NETWORK OF MICHIGAN | 51 | $1.2M |
| Other(8 contracts, 6 carriers) | CONTINENTAL CASUALTY COMPANY - CNA | 49,888 | $3.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 49,888 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
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.