| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | BERKLEY LIFE AND HEALTH INSURANCE COMPANY | — | $59K | $59K | 6.00% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 100878852 | RELIASTAR LIFE INSURANCE COMPANY | $76K | — | $76K | 8.67% |
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | ARAG INSURANCE COMPANY | $5K | — | $5K | 10.00% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | ACE INSURANCE COMPANY | — | $942 | $942 | 19.99% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: DANIEL & HENRY COMPANY | 1001 HIGHLANDS PLAZA DRIVE W SUITE 500 SAINT LOUIS, MO 63110 | ACE INSURANCE COMPANY | $707 | — | $707 | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CONTRACT ADMINISTRATOR | Named fiduciary; Direct payment from the plan; Non-monetary compensation; Contract Administrator; Participant communication; Other services; Float revenue; Claims processing Service code 12 | — | $1.1M |
| EXPRESS SCRIPTS, INC. EIN 22-3461740 3RD PARTY ADMINISTRATOR | Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $241K |
| LINCOLN LIFE ASSURANCE CO OF BOSTON EIN 04-6076039 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $112K |
| DISCOVERY BENEFITS, INC. EIN 90-0058554 RECORD KEEPER | Other fees; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $85K |
| DELTA DENTAL OF MISSOURI EIN 43-0908349 NONE | Claims processing; Contract Administrator Service code 12 | — | $69K |
| BRAVO WELLNESS LLC EIN 61-1739182 NONE | Contract Administrator Service code 13 | — | $42K |
| WILLIS TOWERS WATSON EIN 26-0775680 NONE | Contract Administrator Service code 13 | — | $21K |
| CAREOPERATIVE, LLC EIN 46-4399706 NONE | Other services Service code 49 | — | $18K |
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 | 1,467 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 291 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,758 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision(2 contracts) | COMBINED INSURANCE COMPANY OF AMERICA | 2,437 | $252K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 2,437 | $874K |
| Short-term disability | RELIASTAR LIFE INSURANCE COMPANY | 2,437 | $874K |
| Long-term disability | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 1,641 | $345K |
| Stop-loss / reinsurancereinsurance | BERKLEY LIFE AND HEALTH INSURANCE COMPANY | 1,214 | $987K |
| Other(4 contracts, 4 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 2,437 | $935K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,437 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.