| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA INC. | 2300 RENNAISSANCE BOULEVARD KING OF PRUSSIA, PA 19406 | PRUDENTIAL | $104K | $95K | $199K | 3.82% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL | — | $5K | $5K | 0.10% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA INC. | 2300 RENNAISSANCE BOULEVARD KING OF PRUSSIA, PA 19406 | PRUDENTIAL | $72K | $65K | $137K | 3.82% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL | — | $4K | $4K | 0.10% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCCLENNAN AGENCY | 2300 RENAISSANCE BOULEVARD ATTN 001567 KING OF PRUSSIA, PA 19406 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $59K | $89K | $148K | 5.02% |
| YOUDECIDE, INC.3 | 4450 RIVER GREEN PARKWAY SUITE 100-A DULUTH, GA 30096 | HYATT LEGAL PLANS | $11K | $97 | $12K | 9.86% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HIGHMARK EIN 23-1294723 NA | Contract Administrator; Claims processing Service code 12 | — | $8.2M |
| SEDGWICK EIN 36-2685608 NA | Claims processing Service code 12 | — | $2.0M |
| CAREMARK EIN 95-3382344 NA | Claims processing Service code 12 | — | $672K |
| METLIFE EIN 13-5381829 NA | Claims processing Service code 12 | — | $603K |
| HOOPER HOMES EIN 22-1659359 NA | Contract Administrator Service code 13 | — | $567K |
| SIMPLYWELL EIN 20-0261707 NA | Contract Administrator Service code 13 | — | $385K |
| GEISINGER EIN 04-6076039 NA | Claims processing Service code 12 | — | $345K |
| HEALTH ADVOCATE EIN 23-3080019 NA | Contract Administrator Service code 13 | — | $302K |
| ADVANCE MEDICAL EIN 32-0188784 NA | Contract Administrator Service code 13 | — | $267K |
| VSP EIN 06-1227840 NA | Claims processing Service code 12 | — | $213K |
| PAYFLEX EIN 91-1774434 NA | Contract Administrator Service code 13 | — | $165K |
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 | 26,361 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 26,361 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH & LIFE INSURANCE COMPANY | 12 | $233K |
| Dental | CIGNA HEALTH & LIFE INSURANCE COMPANY | 12 | $233K |
| Life insurance(4 contracts, 3 carriers) | PRUDENTIAL | 48,294 | $8.8M |
| Long-term disability(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 16,320 | $3.0M |
| Other(4 contracts, 4 carriers) | EMPATHIA, INC. | 28,502 | $685K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 48,294 | — |
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.