| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BUCK GLOBAL LLC3 | PO BOX 207640 DALLAS, TX 753200001 | METROPOLITAN LIFE INSURANCE COMPANY | — | $35K | $35K | 2.29% |
| BUCK GLOBAL LLC3 | 200 BERWYN PARK STE 110 BERWYN, PA 193121178 | METROPOLITAN LIFE INSURANCE COMPANY | — | $18 | $18 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH CARE SERVICE CORPORATION EIN 36-1236610 NONE | Direct payment from the plan; Other fees; Contract Administrator Service code 13 | — | $4.7M |
| WILLIS TOWERS WATSON US LLC EIN 53-0181291 NONE | Contract Administrator; Direct payment from the plan; Participant communication Service code 13 | — | $3.0M |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $1.3M |
| CIGNA HEALTH AND LIFE INS. COMPANY EIN 59-1031071 NONE | Direct payment from the plan; Participant communication; Other services; Non-monetary compensation; Claims processing; Float revenue; Contract Administrator Service code 12 | — | $365K |
| CAREMARK EIN 05-0340626 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $299K |
| DELTA DENTAL EIN 36-2612058 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $263K |
| UNITED HEALTHCARE SERVICES, INC EIN 41-1289245 NONE | Claims processing; Direct payment from the plan; Other services Service code 12 | — | $220K |
| ACCLARIS NONE | Other services; Direct payment from the plan Service code 49 | 1511 N WEST SHORE BLVD, STE 350 TAMPA, FL 33607 | $183K |
| MAGELLAN BEHAVIORAL HEALTH EIN 52-2135463 NONE | Contract Administrator; Direct payment from the plan; Other services Service code 13 | — | $182K |
| CAPITOL HR CONSULTING EIN 26-1226363 NONE | Consulting (general); Consulting fees; Consulting (pension); Direct payment from the plan Service code 16 | — | $84K |
| BELL LITHO INC EIN 36-2550923 NONE | Participant communication; Other services; Copying and duplicating; Direct payment from the plan Service code 36 | — | $59K |
| CROWE EIN 35-0921680 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $33K |
| EYEMED VISION CARE LLC EIN 36-2136262 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $12K |
| JPMORGAN CHASE BANK EIN 13-4994650 TRUSTEE | Trustee (bank, trust company, or similar financial institution); Direct payment from the plan; Float revenue; Securities brokerage commissions and fees; Investment management fees paid indirectly by plan; Trustee (directed) Service code 21 | — | $10K |
| O'CONNOR DESIGN, INC. EIN 36-3800364 NONE | Other services; Direct payment from the plan; Consulting (general) Service code 16 | — | $8K |
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 | 12,743 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,783 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 14,526 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(7 contracts, 6 carriers) | UNITEDHEALTHCARE OF OREGON, INC. | 252 | $7.0M |
| Dental | AETNA LIFE INSURANCE COMPANY | 27 | $485K |
| Vision(5 contracts, 2 carriers) | EYEMED VISION CARE | 12,923 | $1.5M |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 11,797 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 12,923 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.