| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | 335 MADISON AVE FL 20 NEW YORK, NY 100174633 | RELIASTAR LIFE INSURANCE COMPANY | — | $189K | $189K | 3.69% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | P O BOX 741909 LOCKBOX 741909 ATLANTA, GA 303741909 | RELIASTAR LIFE INSURANCE COMPANY | $17K | — | $17K | 0.34% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | P O BOX 741909 LOCKBOX 741909 ATLANTA, GA 303741909 | RELIASTAR LIFE INSURANCE COMPANY | $5K | — | $5K | 0.10% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON PENNSYLVANIA INC | P O BOX 8500 LOCKBOX 9102 PHILADELPHIA, PA 191788500 | RELIASTAR LIFE INSURANCE COMPANY | — | $4K | $4K | 0.07% |
| FST ASSOCIATION INC3 | — | METROPOLITAN LIFE INSURANCE COMPANY | $46K | — | $46K | 2.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | — | METROPOLITAN LIFE INSURANCE COMPANY | $6K | — | $6K | 0.36% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON PENNSYLVANIA INC | LOCK BOX 9102 P O BOX 19178 PHILADELPHIA, PA 191780001 | KAISER FOUNDATION HEALTH PLANS INC | $12K | $3K | $14K | 2.59% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | P O BOX 28852P NEW YORK, NY 100878852 | KAISER FOUNDATION HEALTH PLANS INC | $9K | — | $9K | 1.67% |
| MANPOWER INC3 | — | METROPOLITAN LIFE INSURANCE COMPANY | — | $40K | $40K | 8.87% |
| VISION SERVICE PLAN3 | 3333 QUALITY DRIVE RANCHO CORDOVA, CA 95670 | VISION SERVICE PLAN | — | $46K | $46K | 10.62% |
| THE BOON INSURANCE AGENCY3 Filed as: THE BOON INSURANCE AGENCY INC | 6300 BRIDGEPOINT PARKWAY BUILDING 3 #500 AUSTIN, TX 78730 | AETNA LIFE INSURANCE COMPANY | $35K | — | $35K | 8.80% |
| THE BOON INSURANCE AGENCY3 Filed as: THE BOON INSURANCE AGENCY INC | 6300 BRIDGEPOINT PARKWAY BUILDING 3 #500 AUSTIN, TX 78730 | AETNA LIFE INSURANCE COMPANY | $440 | — | $440 | 8.81% |
| HUMANA INSURANCE COMPANY3 | 1100 EMPLOYERS BLVD GREEN BAY, WI 54344 | HUMANA INSURANCE COMPANY | — | $336K | $336K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| METROPOLITAN LIFE INS COMPANY EIN 13-5581829 PLAN ADMINISTRATOR | Consulting (general); Contract Administrator Service code 13 | — | $231K |
| BOON ADMINISTRATIVE SERVICES INC EIN 33-0449333 CONTRACT ADMINISTRATOR | Float revenue Service code 62 | — | $61K |
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 | 8,052 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 8,052 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLANS INC | 660 | $991K |
| Dental(3 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 3,634 | $2.0M |
| Vision(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 3,021 | $21.9M |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 19,565 | $5.1M |
| Short-term disability(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 4,543 | $21.9M |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 4,543 | $451K |
| Other(3 contracts, 3 carriers) | NATIONAL UNION FIRE INS CO OF PITTSBURGH | 7,298 | $566K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 19,565 | — |
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.