| 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 | $613K | — | $613K | 4.67% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $4K | $4K | 0.03% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INS SERVICES INC. | 1125 SANCTUARY PKWY STE 300 ALPHARETTA, GA 30009 | SYMETRA | — | $248K | $248K | 5.65% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BEFEFITS ADVISIOR | 75 STATE STREET #1710 BOSTON, MA 02109 | EYEMED VISION CARE BASIC | $215K | — | $215K | 25.94% |
| AON CONSULTING INC3 Filed as: BSWIFT | 10 S. RIVERSIDE PLAZE STE.1100 CHICAGO, IL 60606 | EYEMED VISION CARE BASIC | $106K | — | $106K | 12.74% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES, LLC | 1120 SANCTUARY PARKWAY, SUITE 300 ALPHARETTA, GA 30009 | ALLSTATE WORKPLACE DIVISION | $64K | — | $64K | 10.14% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SVCS HOUSTON LLC | 1120 SANCTUARY PKWY SUITE 300 ALPHARETTA, GA 30004 | HARTFORD LIFE AND ACCIDENT | $67K | — | $67K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC EIN 33-0441200 PHARMACY BENEFIT MGMT | Other fees; Float revenue; Claims processing; Direct payment from the plan Service code 12 | — | $41.1M |
| UMR,INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $9.7M |
| DELTA DENTAL OF TENNESSEE EIN 62-0812197 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 240 VENTURE CIRCLE NASHVILLE, TN 37228 | $579K |
| BSWIFT LLC THIRD PARY ADMIN FEE | Recordkeeping fees Service code 64 | P.O. BOX 860470 MINNEAPOLIS, MN 55486 | $0 |
| COMPSYCH EIN 35-3739783 THIRD PARY ADMIN FEE | 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 | 20,404 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 20,404 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLANS INC | 1,072 | $11.6M |
| Vision(2 contracts, 2 carriers) | EYEMED VISION CARE PLUS | 16,265 | $2.7M |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 20,404 | $13.1M |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 20,404 | $13.1M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 20,404 | $13.1M |
| Stop-loss / reinsurancereinsurance | SYMETRA | 14,935 | $4.4M |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 21,471 | $14.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 21,471 | — |
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.