| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 | SUITE 300 3635 RIVERSIDE PLAZA DR RIVERSIDE, CA 92506 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $140K | — | $140K | 3.82% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $73K | — | $73K | 2.00% |
| SEDGWICK CLAIMS MANAGEMENT SERVICES5 Filed as: SEDGWICK CLAIMS MGMT SERVICES INC. | 2620 THOUSAND OAKS BLVD. MEMPHIS, TN 38118 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $1.4M | $1.4M | 62.46% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | SUITE 300 3635 RIVERSIDE PLAZA DR RIVERSIDE, CA 92506 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $86K | — | $86K | 3.88% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $66K | — | $66K | 3.00% |
| CARRION, LAFFITTE & CASELLAS, INC.3 Filed as: CARRION LAFFITTE & CASELLAS | 255 AVE PONCE DE LEON SAN JUAN, PR 00917 | TRIPLE S SALUD, INC. | $14K | — | $14K | 2.45% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON PR BROKERAGE, INC | 500 N AKARDS ST 4300 DALLAS, TX 75201 | TRIPLE S SALUD, INC. | $13K | — | $13K | 2.40% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CHOICE HEALTH PLAN EIN 97-0768835 CONTRACT ADMINISTRATOR | Claims processing; Direct payment from the plan Service code 12 | — | $3.8M |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Direct payment from the plan; Contract Administrator; Claims processing Service code 12 | — | $2.6M |
| UNITED HEALTH CARE EIN 36-2739571 CONTRACT ADMINISTRATOR | Claims processing; Direct payment from the plan Service code 12 | — | $2.5M |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 CONTRACT ADMINISTRATOR | Direct payment from the plan; Claims processing Service code 12 | — | $1.7M |
| ALIGHT SOLUTIONS LLC EIN 82-1061233 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general) Service code 15 | — | $1.5M |
| UNITED BEHAVIORAL HEALTH EIN 94-2649097 CONTRACT ADMINISTRATOR | Consulting (pension); Direct payment from the plan Service code 17 | — | $417K |
| KAISER PERMANENTE EIN 94-1340523 CONTRACT ADMINISTRATOR | Direct payment from the plan; Claims processing Service code 12 | — | $395K |
| ERNST & YOUNG EIN 34-6565596 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $53K |
| ROC NONE | Direct payment from the plan; Claims processing Service code 12 | 300 E. RANDOLPH ST SUITE 3400 CHICAGO, IL 60601 | $36K |
| HUB INTERNATIONAL NONE | Direct payment from the plan; Insurance agents and brokers Service code 22 | 55 E. JACKSON BOULEVARD 14TH FLOOR CHICAGO, IL 60604 | $35K |
| AON CONSULTING EIN 22-2230064 NONE | Direct payment from the plan; Consulting (pension) Service code 17 | — | $7K |
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 | 16,062 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,034 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 17,096 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | TRIPLE S SALUD, INC. | 84 | $554K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 7,817 | $3.7M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 7,719 | $2.2M |
| Prescription drug | TRIPLE S SALUD, INC. | 84 | $554K |
| Other | TRIPLE S SALUD, INC. | 84 | $554K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 7,817 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.