| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | 75 STATE STREET SUITE 1710 BOSTON, MA 02109 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $404K | — | $404K | 4.57% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $5K | $5K | 0.06% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | 75 STATE STREET #1710 BOSTON, MA 02109 | EYEMED VISION CARE PLUS | $113K | — | $113K | 7.29% |
| AON CONSULTING INC3 Filed as: BSWIFT | 10 S. RIVERSIDE PLAZA, STE. 1100 CHICAGO, IL 60606 | EYEMED VISION CARE PLUS | $61K | — | $61K | 3.91% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | 75 STATE STREET #1710 BOSTON, MA 02109 | EYEMED VISION CARE BASIC | $38K | — | $38K | 7.31% |
| AON CONSULTING INC3 Filed as: BSWIFT | 10 S. RIVERSIDE PLAZA, STE. 1100 CHICAGO, IL 60606 | EYEMED VISION CARE BASIC | $20K | — | $20K | 3.93% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES, LLC | 1120 SANCTUARY PARKWAY, SUITE 300 ALPHARETTA, GA 30009 | ALLSTATE WORKPLACE DIVISION | $48K | — | $48K | 10.76% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SVCS HOUSTON LLC | 1120 SANCTARY PKWY SUITE 300 ALPHARETTA, GA 30004 | HARTFORD LIFE AND ACCIDENT | $64K | — | $64K | 16.53% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE INSURANCE COMPANY EIN 36-2739571 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | 871 RIDGEWAY LOOP RD SUITE 212 MEMPHIS, TN 38120 | $8.2M |
| DELTA DENTAL OF TENNESSEE EIN 62-0812197 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 240 VENTURE CIRCLE NASHVILLE, TN 37228 | $427K |
| BSWIFT LLC EIN 22-1211670 TPA | Recordkeeping fees Service code 64 | P.O. BOX 860470 MINNEAPOLIS, MN 55486 | $0 |
| COMPSYCH EIN 35-3739783 TPA | Recordkeeping fees Service code 64 | — | $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 | 15,144 | 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. |
| Total participants (= "Plan participants" tile) | 15,144 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLANS INC SO CA | 627 | $6.5M |
| Vision(2 contracts, 2 carriers) | EYEMED VISION CARE PLUS | 13,332 | $2.1M |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 15,144 | $8.9M |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 15,144 | $8.9M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 15,144 | $8.9M |
| Stop-loss / reinsurancereinsurance | SYMETRA | 11,313 | $2.8M |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 15,144 | $9.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 15,144 | — |
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.