| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 12505 PARK POTOMAC AVE #300 POTOMAC, MD 208546804 | SYMETRA LIFE INSURANCE COMPANY | $6K | — | $6K | 1.64% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAREFIRST BLUECROSS BLUESHIELD EIN 53-0078070 CONTRACT ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting (general); Insurance services; Float revenue; Direct payment from the plan; Contract Administrator; Other fees; Claims processing Service code 12 | 10455 MILL RUN CIRCLE OWINGS MILLS, MD 21117 | $150K |
| CVS CAREMARK EIN 05-0304626 CONTRACT ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Insurance services; Other fees; Claims processing; Contract Administrator; Direct payment from the plan; Consulting (general) Service code 12 | 2211 SANDERS ROAD, 10TH FLOOR NORTHBROOK, IA 60062 | $12K |
| BDO USA, P.C. EIN 13-5381590 PLAN AUDITOR | Accounting (including auditing) Service code 10 | 2600 WEST BIG BEAVER ROAD SUITE 600 TROY, MA 48084 | $6K |
| COMERICA BANK EIN 42-1741646 DIRECTED TRUSTEE | Trustee (bank, trust company, or similar financial institution); Other investment fees and expenses; Investment management; Float revenue; Other services; Shareholder servicing fees; Custodial (securities); Other fees Service code 19 | 411 WEST LAFAYETTE BLVD, MC 3462 DETROIT, MI 48226 | $5K |
| SCHWARTZ & CO. EIN 38-2117812 INVESTMENT ADVISOR | Investment advisory (plan) Service code 27 | 3707 W. MAPLE ROAD BLOOMFIELD HILLS, MI 48301 | $5K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 249 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 249 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 138 | $382K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 138 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.