| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VERITAS RISK SERVICES3 Filed as: VERITAS RISK SERVICES - BOR | 3025 HIGHLAND PARKWAY SUITE 650 DOWNERS GROVE, IL 60515 | COMBINED INSURANCE COMPANY OF AMERICA | $10K | — | $10K | 8.71% |
| VERITAS RISK SERVICES3 Filed as: VERITAS RISK SERVICES - BOR | 3025 HIGHLAND PARKWAY SUITE 650 DOWNERS GROVE, IL 60515 | COMBINED INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 8.47% |
| VERITAS RISK SERVICES3 Filed as: VERITAS RISK SERVICES - BOR | 3025 HIGHLAND PARKWAY SUITE 650 DOWNERS GROVE, IL 60515 | COMBINED INSURANCE COMPANY OF AMERICA | $128 | — | $128 | 9.36% |
| VERITAS RISK SERVICES3 Filed as: VERITAS RISK SERVICES - BOR | 3025 HIGHLAND PARKWAY SUITE 650 DOWNERS GROVE, IL 60515 | COMBINED INSURANCE COMPANY OF AMERICA | $133 | — | $133 | 10.42% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITEDHEALTH GROUP EIN 41-1321939 NONE | Claims processing Service code 12 | — | $720K |
| EXPRESS SCRIPTS EIN 22-3461740 NONE | Claims processing Service code 12 | — | $55K |
| UNITED BEHAVIORAL HEALTH DBA OPTUM EIN 94-2649097 NONE | Claims processing Service code 12 | — | $38K |
| DELTA DENTAL OF WI EIN 39-6094742 NONE | Claims processing Service code 12 | — | $34K |
| DELTA DENTAL OF IL EIN 36-2612058 NONE | Claims processing Service code 12 | — | $19K |
| TOWERS WATSON DELAWARE EIN 53-0181291 NONE | Actuarial; Other services; Consulting (general) Service code 11 | — | $6K |
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 | 1,098 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 676 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,774 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. | 616 | $1.8M |
| Dental(2 contracts, 2 carriers) | CARE-PLUS DENTAL PLANS, INC. | 26 | $40K |
| Vision(4 contracts) | COMBINED INSURANCE COMPANY OF AMERICA | 1,238 | $171K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,238 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.