| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RUST INSURANCE AGENCY LLC3 Filed as: RUST INSURANCE AGENCY | 910 17TH STREET NW WASHINGTON, DC 20006 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH | $15K | — | $15K | 20.00% |
| RUST INSURANCE AGENCY LLC3 Filed as: RUST INSURANCE AGENCY | 910 17TH STREET NW WASHINGTON, DC 20006 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH | $9K | — | $9K | 20.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SERVICE MANAGEMENT CORPORATION EIN 52-1200541 SUBSIDIARY OF NTCA | Direct payment from the plan; Contract Administrator Service code 13 | — | $11.1M |
| UNITED HEALTHCARE INSURANCE COMPANY EIN 36-2739571 NONE | Consulting (general); Other fees; Other services; Direct payment from the plan Service code 16 | — | $6.9M |
| HEALTH AXIS EIN 75-2968705 NONE | Contract Administrator; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 13 | — | $830K |
| OPTUM EIN 41-1591944 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $780K |
| HEALTHWAYS EIN 62-1117144 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $593K |
| TOWERS WATSON EIN 53-0181291 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $441K |
| GROOM LAW GROUP EIN 52-1219029 NONE | Legal; Direct payment from the plan Service code 29 | — | $386K |
| MEDCO EIN 22-3461740 NONE | Direct payment from the plan; Other services Service code 49 | — | $341K |
| VISION SERVICE PLAN EIN 06-1227840 NONE | Direct payment from the plan; Other services Service code 49 | — | $257K |
| TRIUNE TECHONOLOGIES EIN 30-0057733 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $195K |
| WILSHIRE ASSOCIATES EIN 95-2755361 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $70K |
| CLARK COMMUNICATIONS, INC. EIN 56-1463810 NONE | Direct payment from the plan; Copying and duplicating Service code 36 | — | $51K |
| MEDICAL REVIEW INSTITUTE EIN 87-0394756 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $44K |
| CLIFTONLARSONALLEN, LLP EIN 47-0746749 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $37K |
| BLACKROCK INSTITUTIONAL TRUST CO. EIN 94-3112180 NONE | Direct payment from the plan; Investment management; Trustee (bank, trust company, or similar financial institution); Investment management fees paid directly by plan; Trustee (discretionary) Service code 21 | — | $31K |
| GENEX SERVICES EIN 23-1728483 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $29K |
| ACCENT COST CONTAINMENT SOLUTIONS EIN 20-1802547 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $18K |
| MAIL MANAGEMENT SERVICES EIN 56-2075508 NONE | Direct payment from the plan; Other services Service code 49 | — | $17K |
| BECKY DOOLEY EIN 83-0305926 TRUSTEE | Trustee (individual); Direct payment from the plan Service code 20 | — | $8K |
| MARK HARVEY EIN 42-0654387 TRUSTEE | Trustee (individual); Direct payment from the plan Service code 20 | — | $7K |
| JOSEPH SNYDER EIN 42-0181770 TRUSTEE | Trustee (individual); Direct payment from the plan Service code 20 | — | $6K |
| KEITH GIBSON EIN 71-0350210 TRUSTEE | Direct payment from the plan; Trustee (individual) Service code 20 | — | $6K |
| TONEY PRATHER EIN 75-0873589 TRUSTEE | Direct payment from the plan; Trustee (individual) Service code 20 | — | $6K |
| JAMES SIMON EIN 43-0692435 TRUSTEE | Trustee (individual); Direct payment from the plan Service code 20 | — | $6K |
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 | 24,765 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2,554 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 27,319 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | ING RELIASTAR LIFE INSURANCE COMPANY | 24,267 | $4.1M |
| Other(3 contracts, 2 carriers) | ING RELIASTAR LIFE INSURANCE COMPANY | 24,267 | $4.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 24,267 | — |
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.
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.