| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 | 335 MADISON AVE FL 20 NEW YORK, NY 10017 | RELIASTAR LIFE INSURANCE COMPANY | — | $332K | $332K | 6.00% |
| RINGMASTER INSURANCE AGENCY LLC3 | 5200 TOWN CENTER CIR STE 540 BOCA RATON, FL 334861018 | RELIASTAR LIFE INSURANCE COMPANY | — | $1K | $1K | 0.02% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | STANDARD INSURANCE COMPANY | $94K | — | $94K | 2.64% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | STANDARD INSURANCE COMPANY | $138K | — | $138K | 6.38% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST, INC | 200 LIBERTY STREET NEW YORK, NY 10281 | ELIXIR | $25K | — | $25K | 4.21% |
| AMWINS5 Filed as: AMWINS GROUP BENEFITS LLC | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | ELIXIR | $20K | — | $20K | 3.30% |
| AMWINS5 Filed as: AMWINS GROUP BENEFITS, LLC | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | COMPANION LIFE INSURANCE COMPANY - COLUMBIA | $40K | — | $40K | 9.29% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST, INC | 200 LIBERTY STREET NEW YORK, NY 10281 | COMPANION LIFE INSURANCE COMPANY - COLUMBIA | $14K | — | $14K | 3.28% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ROCKY MOUNTAIN HOSPITAL & MEDICAL EIN 84-0747736 | Claims processing; Float revenue; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 12 | — | $5.0M |
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 | 5,758 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 494 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 6,252 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 714 | $8.1M |
| Dental(3 contracts, 3 carriers) | AMERITAS LIFE INSURANCE CORP. | 706 | $413K |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 6,147 | $1.3M |
| Life insurance | STANDARD INSURANCE COMPANY | 6,494 | $3.5M |
| Long-term disability | STANDARD INSURANCE COMPANY | 5,970 | $2.2M |
| Other(2 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 6,437 | $5.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,494 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.