| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES | 21300 VICTORY BOULEVARD SUITE 635 WOODLAND HILLS, CA 913672525 | METROPOLITAN LIFE INSURANCE COMPANY | $30K | $23K | $53K | 1.77% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | 321 N. CLARK STREET SUITE 940 CHICAGO, IL 606545015 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | $5K | $13K | 0.43% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES | 21300 VICTORY BOULEVARD SUITE 635 WOODLAND HILLS, CA 913672525 | METROPOLITAN LIFE INSURANCE COMPANY | — | $192 | $192 | 0.01% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | PO BOX 905494 CHARLOTTE, NC 282905494 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $11K | — | $11K | 4.89% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | PO BOX 905494 CHARLOTTE, NC 28290 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD EIN 36-1236610 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $2.9M |
| EXPRESS SCRIPTS EIN 22-3461740 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $211K |
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $180K |
| AON HEWITT EIN 36-2235791 CLAIMS ADMINISTRATOR | Other fees; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $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 | 13,453 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 112 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 13,565 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | TRIPLE S SALUD, INC. | 143 | $841K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 5,889 | $757K |
| Life insurance(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 10,813 | $3.0M |
| Short-term disability(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 10,813 | $3.0M |
| Long-term disability(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 10,813 | $3.0M |
| Prescription drug | TRIPLE S SALUD, INC. | 143 | $841K |
| Other(7 contracts, 2 carriers) | TRIPLE S SALUD, INC. | 7,721 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 10,813 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.