| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EOI SERVICE COMPANY INC3 Filed as: EOI SERVICE COMPANY, INC. | 1820 EAST FIRST STREET, SUITE 400 SANTA ANA, CA 92705 | RELIASTAR LIFE INSURANCE COMPANY | $155K | — | $155K | 2.49% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE, INC. | 335 MADISON AVENUE, FLOOR 20 NEW YORK, NY 100174633 | RELIASTAR LIFE INSURANCE COMPANY | — | $101K | $101K | 1.63% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE, INC. | P.O. BOX 28852 NEW YORK, NY 100878852 | RELIASTAR LIFE INSURANCE COMPANY | $63K | — | $63K | 1.01% |
| EOI SERVICE COMPANY INC3 Filed as: EOI SERVICE COMPANY, INC. | 1820 EAST FIRST STREET, SUITE 400 SANTA ANA, CA 92705 | RELIASTAR LIFE INSURANCE COMPANY | $3K | — | $3K | 0.05% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF ILLINOIS EIN 36-1236610 NONE | Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $2.9M |
| UNITED HEALTHCARE SERVICES INC. EIN 41-1289245 NONE | Direct payment from the plan; Claims processing; Other services Service code 12 | — | $2.6M |
| MEDCO HEALTH SOLUTIONS, INC. EIN 22-3461740 NONE | Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | — | $551K |
| UMR, INC. EIN 39-1995276 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $446K |
| PAYFLEX SYSTEMS USA, INC. NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 10802 FARNAM DRIVE OMAHA, NE 68154 | $341K |
| THE HARTFORD NONE | Direct payment from the plan; Contract Administrator Service code 13 | ONE HARTFORD PLAZA HARTFORD, CT 06155 | $295K |
| ACTIVEHEALTH MANAGEMENT, INC. EIN 52-2182411 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $281K |
| TOWERS WATSON PENNSYLVANIA, INC. EIN 39-1263473 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $280K |
| DELTA DENTAL EIN 36-2612058 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $263K |
| SAN FRANCISCO HEALTH SECURITY NONE | Direct payment from the plan; Contract Administrator Service code 13 | P.O. BOX 194367 SAN FRANCISCO, CA 941194367 | $123K |
| BUSINESS HEALTHCARE GROUP, LLC EIN 45-3218879 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $114K |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 NONE | Contract Administrator; Claims processing; Direct payment from the plan Service code 12 | — | $97K |
| THE ROC GROUP EIN 36-4220885 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $61K |
| VEDDER PRICE EIN 36-3254526 NONE | Legal; Direct payment from the plan Service code 29 | — | $21K |
| QUARLES & BRADY, LLP EIN 39-0432630 NONE | Legal; Direct payment from the plan Service code 29 | — | $18K |
| HBD INTERNATIONAL NONE | Direct payment from the plan; Contract Administrator Service code 13 | P.O. BOX 2512 PROVIDENCE, RI 02906 | $8K |
| MIDWEST HEALTH PURCHASERS EIN 36-3059249 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $6K |
| MEDICAL COLLEGE OF WISCONSIN NONE | Direct payment from the plan; Other services Service code 49 | 8701 WATERTOWN PLANK ROAD MILWAUKEE, WI 53226 | $5K |
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 | 9,355 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2,184 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 11,539 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(11 contracts, 8 carriers) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 10,610 | $74.9M |
| Dental(2 contracts) | AETNA LIFE INSURANCE COMPANY | 4,313 | $1.4M |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 8,699 | $1.6M |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 31,607 | $6.2M |
| Short-term disability | SUN LIFE INSURANCE COMPANY | 5,357 | $687K |
| Prescription drug | UNITY HEALTH PLANS INSURANCE CORPORATION | 225 | $1.7M |
| Other(2 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 31,607 | $6.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 31,607 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
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.