| 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 | $17K | — | $17K | 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 | $8K | — | $8K | 20.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SERVICE MANAGEMENT CORPORATION EIN 52-1200541 SUBSIDIARY OF NTCA | Contract Administrator; Direct payment from the plan Service code 13 | — | $11.4M |
| UNITED HEALTHCARE INSURANCE COMPANY EIN 36-2739571 NONE | Other fees; Other services; Consulting (general); Direct payment from the plan Service code 16 | — | $7.3M |
| HEALTH AXIS EIN 75-2968705 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 13 | — | $1.0M |
| OPTUM EIN 41-1591944 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $637K |
| HEALTHWAYS EIN 62-1117144 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $632K |
| EXPRESS SCRIPTS EIN 22-3461740 NONE | Direct payment from the plan; Other services Service code 49 | — | $568K |
| TOWERS WATSON EIN 53-0181291 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $427K |
| GROOM LAW GROUP EIN 52-1219029 NONE | Legal; Direct payment from the plan Service code 29 | — | $331K |
| VISION SERVICE PLAN EIN 06-1227840 NONE | Other services; Direct payment from the plan Service code 49 | — | $267K |
| TRIUNE TECHONOLOGIES EIN 30-0057733 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $215K |
| MEDICAL REVIEW INSTITUTE EIN 87-0394756 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $113K |
| CLARK COMMUNICATIONS, INC. EIN 56-1463810 NONE | Copying and duplicating; Direct payment from the plan Service code 36 | — | $63K |
| WILSHIRE ASSOCIATES EIN 95-2755361 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $40K |
| CLIFTONLARSONALLEN, LLP EIN 47-0746749 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $32K |
| GENEX SERVICES EIN 23-1728483 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $18K |
| MAIL MANAGEMENT SERVICES EIN 56-2075508 NONE | Direct payment from the plan; Other services Service code 49 | — | $18K |
| BLACKROCK INSTITUTIONAL TRUST CO. EIN 94-3112180 NONE | Investment management fees paid directly by plan; Trustee (bank, trust company, or similar financial institution); Direct payment from the plan; Trustee (discretionary); Investment management Service code 21 | — | $12K |
| KRISTI WESTBROOK EIN 41-0721924 TRUSTEE | Trustee (individual); Direct payment from the plan Service code 20 | — | $9K |
| TONEY PRATHER EIN 75-0873589 TRUSTEE | Trustee (individual); Direct payment from the plan Service code 20 | — | $9K |
| BECKY DOOLEY EIN 83-0305926 TRUSTEE | Direct payment from the plan; Trustee (individual) Service code 20 | — | $8K |
| KEITH GIBSON EIN 71-0350210 TRUSTEE | Trustee (individual); Direct payment from the plan Service code 20 | — | $7K |
| MARK HARVEY EIN 42-0654387 TRUSTEE | Direct payment from the plan; Trustee (individual) Service code 20 | — | $7K |
| JOSEPH SNYDER EIN 42-0181770 TRUSTEE | Direct payment from the plan; Trustee (individual) 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 | 25,255 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2,705 | Continuation coverage (COBRA, retiree health). |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 27,960 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | ING RELIASTAR LIFE INSURANCE COMPANY | 13,924 | $4.7M |
| Other(3 contracts, 2 carriers) | ING RELIASTAR LIFE INSURANCE COMPANY | 13,924 | $4.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 13,924 | — |
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.