| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 330 MADISON AVE. 7TH FLOOR NEW YORK, NY 10017 | AETNA LIFE INSURANCE COMPANY | $15K | — | $15K | 1.49% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MARYLAND INC | 12505 PARK POTOMAC AVE SUITE 300 POTOMAC, MD 20854 | AETNA LIFE INSURANCE COMPANY | $12K | — | $12K | 1.25% |
| WELLS FARGO INSURANCE SERVICES3 | USA INC. 330 MADISON AVE. 7TH FLOOR NEW YORK, NY 10017 | AETNA LIFE INSURANCE COMPANY | $2K | — | $2K | 0.23% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 330 MADISON AVE. 7TH FLOOR NEW YORK, NY 10177 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $8K | — | $8K | 1.19% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MARYLAND, INC | 225 SCHILLING CIRCLE, STE 150 HUNT VALLEY, MD 21031 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $6K | — | $6K | 0.82% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATITIONAL, | INC. PO BOX 203014 DALLAS, TX 75320 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $6K | $3K | $10K | 2.10% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MARYLAND, INC. | PO BOX 13784 NEWARK, NJ 07188 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $3K | — | $3K | 0.65% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL, | INC. 150 N MICHIGAN AVE STE 3900 CHICAGO, IL 60601 | KAISER FOUNDATION HEALTH PLAN INC | $4K | — | $4K | 1.56% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MARYLAND, INC | 12505 PARK POTOMAC AVE, STE 300 POTOMAC, MD 20854 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 0.92% |
| TERENCE EDWARD BURKE3 | UNKNOWN ASHBURN, VA 20147 | TRIPLE S SALUD, INC. | $4K | — | $4K | 5.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS ADMIN, LLC | PO BOX 310502 DES MOINES, IA 50331 | CONTINENTAL AMERICAN INSURANCE COMPANY | $9K | — | $9K | 12.45% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL, | INC. PO BOX 203510 DALLAS, TX 75320 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | — | $3K | 4.85% |
| DARYL DIBLER3 | 102 SUPREME CT EAST PEORIA, IL 61611 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | — | $3K | 4.16% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC (NY) | 2580 GOLF ROAD ROLLING MEADOWS, IL 60008 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 3.42% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator; Direct payment from the plan; Participant communication; Float revenue; Other services; Non-monetary compensation; Named fiduciary Service code 12 | 280 TRUMBULL ST. 5 HARTFORD, CT 06103 | $758K |
| NATIVE AMERICAN INSURANCE SERVICES EIN 26-0004545 NONE | Contract Administrator Service code 13 | 102 SUPREME COURT EAST PEORIA, IL 616111442 | $347K |
| CIGNA BEHVIORAL HEALTH, INC. EIN 41-1648670 CONTRACT ADMINISTRATOR | Claims processing; Participant communication; Contract Administrator; Direct payment from the plan Service code 12 | — | $26K |
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 | 1,488 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 60 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,561 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | 69 | $821K |
| Vision | VISION SERVICE PLAN | 944 | $156K |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 1,563 | $974K |
| Short-term disability | AETNA LIFE INSURANCE COMPANY | 1,563 | $974K |
| Long-term disability | AETNA LIFE INSURANCE COMPANY | 1,563 | $974K |
| Prescription drug(5 contracts, 5 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | 69 | $821K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,734 | $681K |
| Other(3 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 1,563 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,734 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.