| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEWITT INSURANCE BROKERAGE LLC3 | 39030 TREASURY CENTER CHICAGO, IL 606949000 | UNITED HEALTHCARE INSURANCE COMPANY | $177K | — | $177K | 1.86% |
| HEWITT INSURANCE BROKERAGE LLC3 | 39030 TREASURY CENTER CHICAGO, IL 606949000 | UNITED HEALTHCARE OF CALIFORNIA | $682 | — | $682 | 2.00% |
| HEWITT INSURANCE BROKERAGE LLC3 Filed as: HEWITT INSURANCE BROKERAGE, LLC | 39030 TREASURY CENTER CHICAGO, IL 606949000 | HEALTH NET | $469 | — | $469 | 1.96% |
| HEWITT INSURANCE BROKERAGE LLC3 | 39030 TREASURY CENTER CHICAGO, ID 606949000 | KAISER FOUNDATION HEALTH PLAN INC. | $307 | — | $307 | 1.83% |
| HEWITT INSURANCE BROKERAGE LLC3 Filed as: HEWITT INSURANCE BROKERAGE, LLC | 39030 TREASURY CENTER CHICAGO, IL 606949000 | HEALTH NET | $111 | — | $111 | 2.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MAYER HOFFMAN MCCANN, P.C. EIN 43-1947695 AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $22K |
| STATE STREET BANK & TRUST EIN 04-1867445 TRUSTEE | Trustee (directed); Investment management Service code 25 | — | $22K |
| AMERICAN CENTURY INVESTMENTS EIN 04-0640487 INVESTMENT ADVISOR | Investment management; Investment management fees paid directly by plan; Investment management fees paid indirectly by plan Service code 28 | — | $1K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2,682 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,682 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 4 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 1,036 | $10.1M |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 2,213 | $3.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,213 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.