| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SURVIVOR OUTREACH SERVICES5 Filed as: SURVIVOR OUTREACH SERVICES, LLC | 6800 BISHOP ROAD SUITE 220 PLANO, TX 750244275 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $318K | $318K | 1.29% |
| HARVARD PRINTING GROUP5 | 175 US HIGHWAY 46 WEST FAIRFIELD, NJ 070042327 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $64K | $64K | 0.26% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $49K | $49K | 0.20% |
| FRED MAXWELL - ACIUS GROUP3 Filed as: FRED MAXWELL | ACIUS GROUP SUITE 203, 2591 DALLAS PARKWAY FRISCO, TX 75034 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $25K | — | $25K | 0.10% |
| UNITED ENVELOPE LLC5 Filed as: UNITED ENVELOPE | P.O. BOX 951431 CLEVELAND, OH 44193 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $3K | $3K | 0.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF MISSOURI EIN 43-0908349 CONTRACT ADMIN | Claims processing; Contract Administrator; Account maintenance fees; Recordkeeping fees; Direct payment from the plan Service code 12 | — | $2.1M |
| SEDGWICK CMS EIN 36-2685608 CONTRACT ADMIN | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Direct payment from the plan; Account maintenance fees; Contract Administrator; Recordkeeping fees Service code 12 | — | $1.5M |
| CIGNA EIN 59-1031071 CONTRACT ADMINISTRATOR | Participant communication; Direct payment from the plan; Contract Administrator; Other services; Claims processing Service code 12 | — | $1.4M |
| LIFEWORKS EIN 81-1114266 CONTRACT ADMINISTRATOR | Direct payment from the plan; Contract Administrator Service code 13 | — | $1.2M |
| ASCENSION HEALTH EIN 31-1662309 PLAN ADMINISTRATOR | Direct payment from the plan; Plan Administrator Service code 14 | — | $1.1M |
| VISION SERVICE PLAN EIN 36-3560825 CONTRACT ADMINISTRATOR | Contract Administrator; Recordkeeping fees; Account maintenance fees; Direct payment from the plan; Claims processing Service code 12 | — | $965K |
| GREENSFELDER, HEMKER & GALE, PC EIN 43-1313567 LEGAL | Legal; Direct payment from the plan Service code 29 | — | $324K |
| MEDIMPACT HEALTHCARE SYSTEMS, INC. EIN 33-0567651 CONTRACT ADMIN | Account maintenance fees; Direct payment from the plan; Recordkeeping fees; Claims processing; Contract Administrator Service code 12 | — | $205K |
| WESTERN ASSET MGMT & CO. EIN 95-2705767 INVESTMENT MANAGER | Investment management; Investment management fees paid directly by plan Service code 28 | — | $139K |
| STATE STREET BANK & TRUST COMPANY EIN 04-1867445 TRUSTEE | Account maintenance fees; Trustee (directed); Recordkeeping fees Service code 25 | — | $76K |
| IRONBRIDGE CAPITAL MANAGEMENT, L.P. EIN 36-4255832 INVESTMENT MANAGER | Investment management; Investment management fees paid directly by plan Service code 28 | — | $73K |
| TOWERS WATSON DELAWARE, INC. EIN 53-0181291 CONSULTING | Consulting (general); Actuarial; Direct payment from the plan Service code 11 | — | $55K |
| CLIFTON LARSON ALLEN EIN 41-0746749 AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $48K |
| TARGETED COMMUNICATIONS EIN 20-8314566 CONSULTING | Direct payment from the plan; Consulting (general) Service code 16 | — | $47K |
| CREATIVE DESIGN & WRITING SOLUTIONS EIN 47-3231431 CONSULTING | Direct payment from the plan; Consulting (general) Service code 16 | — | $45K |
| KNOWLEDGE BY DESIGN, LLC EIN 46-3778219 CONSULTING | Direct payment from the plan; Consulting (general) Service code 16 | — | $40K |
| BUCK CONSULTING, LLC EIN 13-3954297 CONSULTING | Consulting (general); Direct payment from the plan Service code 16 | — | $38K |
| AON HEWITT EIN 22-2232264 CONSULTING | Copying and duplicating; Direct payment from the plan; Consulting (general) Service code 16 | — | $33K |
| CLARA YOCHUM EIN 30-4529336 CONSULTING | Direct payment from the plan; Consulting (general) Service code 16 | — | $28K |
| ELAVIO INC EIN 35-2134946 CONSULTING | Consulting (general); Direct payment from the plan Service code 16 | — | $16K |
| BLACKROCK INSTITUTIONAL TRUST CO EIN 94-3112180 INVESTMENT MANAGER | Investment management; Investment management fees paid directly by plan Service code 28 | — | $16K |
| HRSOFT USA, INC EIN 01-0560270 OTHER SERVICES | Direct payment from the plan; Other services Service code 49 | — | $14K |
| OBATA DESIGN, INC EIN 43-0795933 CONSULTING | Direct payment from the plan; Consulting (general) Service code 16 | — | $7K |
| NONOBVIOUS SOLUTIONS, LLC CONSULTING | Direct payment from the plan; Consulting (general) Service code 16 | 15 CONWAY LANE ST LOUIS, MO 63124 | $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 | 123,673 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2,412 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 126,085 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 171,732 | $32.1M |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 530 | $230K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 171,732 | — |
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.