| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 100878852 | METROPOLITAN LIFE INSURANCE COMPANY | — | $48 | $48 | 0.00% |
| RUST INSURANCE AGENCY LLC3 | 1510 H STREET NW, 5TH FLOOR WASHINGTON, DC 20005 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH | $13K | — | $13K | 20.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SERVICES MANAGEMENT CORPORATION EIN 52-1200541 SUBSIDIARY OF NTCA | Contract Administrator; Direct payment from the plan Service code 13 | — | $15.2M |
| UNITED HEALTHCARE INSURANCE COMPANY EIN 36-2739571 NONE | Other services; Direct payment from the plan; Consulting (general) Service code 16 | — | $8.6M |
| EXPRESS SCRIPTS EIN 22-3461740 NONE | Direct payment from the plan; Other services Service code 49 | — | $7.4M |
| HEALTH AXIS EIN 75-2968705 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Direct payment from the plan Service code 13 | — | $1.2M |
| WILLIS TOWERS WATSON EIN 53-0181291 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $601K |
| OPTUM EIN 41-1591944 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $554K |
| VIVEKA HEALTH INC. EIN 86-2467157 NONE | Direct payment from the plan; Other services Service code 49 | — | $497K |
| MEDICAL REVIEW INSTITUTE EIN 87-0394756 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $300K |
| GROOM LAW GROUP EIN 52-1219029 NONE | Legal; Direct payment from the plan Service code 29 | — | $264K |
| TELUS HEALTH EIN 52-1883918 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $209K |
| VISION SERVICE PLAN EIN 06-1227840 NONE | Direct payment from the plan; Other services Service code 49 | — | $198K |
| EVICORE HEALTHCARE EIN 62-1615395 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $147K |
| CLARK'S PRINTING SERVICE, INC. EIN 56-1463810 NONE | Direct payment from the plan; Other services Service code 49 | — | $77K |
| BANK OF AMERICA EIN 56-0906609 NONE | Direct payment from the plan; Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $54K |
| FORVIS MAZARS, LLP EIN 44-0160260 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $52K |
| EMPERION SERVICES INC EIN 99-2791037 NONE | Direct payment from the plan; Other services Service code 49 | — | $50K |
| WILSHIRE ASSOCIATES EIN 95-2755361 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $40K |
| PNC BANK EIN 22-1146430 NONE | Trustee (bank, trust company, or similar financial institution); Direct payment from the plan Service code 21 | — | $25K |
| FITNESS ON DEMAND EIN 86-1750099 NONE | Direct payment from the plan; Other services Service code 49 | — | $12K |
| TRUSTEE #1 TRUSTEE | Direct payment from the plan; Trustee (individual); Non-monetary compensation Service code 20 | 4121 WILSON BLVD, STE 1000 ARLINGTON, VA 22203 | $11K |
| EXAM COORDINATORS NETWORK EIN 95-3327434 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $11K |
| TRUSTEE #2 TRUSTEE | Non-monetary compensation; Trustee (individual); Direct payment from the plan Service code 20 | 4121 WILSON BLVD, STE 1000 ARLINGTON, VA 22203 | $10K |
| TRUSTEE #3 TRUSTEE | Direct payment from the plan; Trustee (individual); Non-monetary compensation Service code 20 | 4121 WILSON BLVD, STE 1000 ARLINGTON, VA 22203 | $10K |
| BLACKROCK INSTITUTIONAL TRUST CO EIN 94-3112180 NONE | Investment management fees paid directly by plan; Trustee (bank, trust company, or similar financial institution); Trustee (discretionary); Direct payment from the plan; Investment management Service code 21 | — | $9K |
| TRUSTEE #4 TRUSTEE | Trustee (individual); Direct payment from the plan; Non-monetary compensation Service code 20 | 4121 WILSON BLVD, STE 1000 ARLINGTON, VA 22203 | $9K |
| TRUSTEE #5 TRUSTEE | Non-monetary compensation; Trustee (individual); Direct payment from the plan Service code 20 | 4121 WILSON BLVD, STE 1000 ARLINGTON, VA 22203 | $8K |
| TRUSTEE #6 TRUSTEE | Trustee (individual); Direct payment from the plan; Non-monetary compensation Service code 20 | 4121 WILSON BLVD, STE 1000 ARLINGTON, VA 22203 | $7K |
| CHRISTOPHER REBOL, DDS PA EIN 26-2953796 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $7K |
| TRUSTEE #7 TRUSTEE | Direct payment from the plan; Non-monetary compensation; Trustee (individual) Service code 20 | 4121 WILSON BLVD, STE 1000 ARLINGTON, VA 22203 | $7K |
| TRUSTEE #8 TRUSTEE | Non-monetary compensation; Trustee (individual); Direct payment from the plan Service code 20 | 4121 WILSON BLVD, STE 1000 ARLINGTON, VA 22203 | $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 | 17,341 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3,691 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 21,032 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 30,159 | $5.3M |
| Other(3 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 30,159 | $5.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 30,159 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.