| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EPIC3 Filed as: EPIC HEARING SERVICES | 3191 W TEMPLE AVE SUITE 200 PONOMA, CA 91768 | FIDELITY SECURITY LIFE INSURANCE COMPANY | — | $18K | $18K | 11.00% |
| FORREST T JONES AND COMPANY, INC3 Filed as: FORREST T. JONES & COMPANY | 3130 BROADWAY KANSAS CITY, MA 64111 | FIDELITY SECURITY LIFE INSURANCE COMPANY | — | $8K | $8K | 5.00% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 Filed as: BLUE CROSS BLUE SHIELD MN | 1750 YANKEE DOODLE ROAD EAGEN, MN 55121 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $8K | — | $8K | 5.00% |
| RESLTN REINSURANCE INTERMEDIARES CO3 | 4408 FORREST DRIVE SUITE 202 COLUMBIA, SC 29206 | FIDELITY SECURITY LIFE INSURANCE COMPANY | — | $3K | $3K | 2.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTH CARE EIN 36-2735971 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $22.5M |
| ALIGHT SOLUTIONS LLC EIN 82-1061233 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $3.7M |
| EXPRESS SCRIPTS INC. EIN 43-1420563 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $2.2M |
| DELTA DENTAL MN EIN 41-0952670 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $1.6M |
| U.S. BANK N.A. EIN 41-6271370 PLAN SPONSOR | Employee (plan sponsor); Direct payment from the plan; Trustee (directed) Service code 25 | — | $567K |
| WILLIS TOWERS WATSON EIN 53-0181291 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $328K |
| JELLYVISION EIN 36-4442819 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $85K |
| WEIGHT WATCHERS EIN 52-1656141 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $44K |
| STATE STREET GLOBAL ADVISORS EIN 81-4017137 NONE | Investment management; Custodial (other than securities); Custodial (securities); Direct payment from the plan; Investment management fees paid directly by plan; Other fees Service code 18 | — | $19K |
| DORSEY & WHITNEY LLP EIN 41-0223337 NONE | Legal; Direct payment from the plan Service code 29 | — | $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 | 57,397 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4,888 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 62,285 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(9 contracts, 7 carriers) | KAISER FOUNDATION HEALTH PLAN, INC | 20,755 | $31.0M |
| Vision | COMBINED INSURANCE COMPANY OF AMERICA | 115,210 | $6.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 115,210 | — |
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.