| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | 200 LIBERTY STREET, FLOOR 3 NEW YORK, NY 10281 | HCC LIFE INSURANCE COMPANY | $23K | — | $23K | 2.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BL. CR. LF AND HLTH INS. CO. EIN 95-4331852 CONTRACT ADMNSTRTR | Direct payment from the plan; Contract Administrator; Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 12 | — | $2.9M |
| EMPYREAN BENEFIT SOLUTIONS, INC. EIN 20-3029813 CONTRACT ADMNSTRTR | Contract Administrator; Direct payment from the plan Service code 13 | — | $242K |
| DELTA DENTAL OF CALIFORNIA EIN 94-1461312 CONTRACT ADMNSTRTR | Direct payment from the plan; Contract Administrator; Claims processing Service code 12 | — | $98K |
| MOSS ADAMS LLP EIN 91-0189318 AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $78K |
| HEALTH EQUITY EIN 52-2383166 CONTRACT ADMNSTRTR | Direct payment from the plan; Contract Administrator Service code 13 | — | $69K |
| FTBA, INC. EIN 46-4314843 PLAN SPONSOR | Plan Administrator; Direct payment from the plan Service code 14 | — | $53K |
| OG LAW EIN 92-3715595 ATTORNEY | Direct payment from the plan; Plan Administrator Service code 14 | — | $38K |
| VISION SERVICE PLAN EIN 94-1632821 CONTRACT ADMNSTRTR | Contract Administrator; Direct payment from the plan Service code 13 | — | $37K |
| PILLSBURY WINTHROP SHAW PITTMAN LP EIN 94-1311126 ATTORNEY | Legal; Direct payment from the plan Service code 29 | — | $30K |
| HEALTH ADVOCATE CONTRACT ADMNSTRTR | Direct payment from the plan; Contract Administrator Service code 13 | 3043 WALTON ROAD, SUITE 150 PLYMOUTH MEETING, PA 19462 | $25K |
| U.S. BANK NATIONAL ASSOCIATION EIN 31-0841368 TRUSTEE | Trustee (bank, trust company, or similar financial institution); Direct payment from the plan Service code 21 | — | $11K |
| ALIGHT SOLUTIONS LLC EIN 36-2235791 CONSULTANT | Consulting (general); Direct payment from the plan Service code 16 | — | $9K |
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 | 1,861 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 33 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 32 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,926 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 69 | $1.4M |
| Prescription drug(4 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 69 | $1.3M |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 1,595 | $917K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,595 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.