| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AON CONSULTING INC3 | 4 OVERLOOK POINT LINCOLNSHIRE, IL 60069 | UNIVERA / EXCELLUS HEALTH PLAN | $120K | $1K | $121K | 1.01% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | 111 MARKET PL. BALTIMORE, MD 212024035 | OPTIMA HEALTH PLAN | $114K | — | $114K | 1.01% |
| CHARLES R IEUTER3 Filed as: CHARLES S. NELSON | AMERICAN BENEFIT SERVICES INC. PO BOX 639 WILMETTE, IL 600910639 | INDEPENDENT HEALTH | — | — | $0 | 0.00% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. -IL | PO BOX 905494 CHARLOTTE, NC 28290 | KAISER FOUNDATION HEALTH PLAN,INC. (CALIFORNIA) | $84K | — | $84K | 0.91% |
| CHARLES R IEUTER3 Filed as: CHARLES SPENCER NELSON | PO BOX 639 WILMETTE, IL 60091 | KAISER FOUNDATION HEALTH PLAN,INC. (CALIFORNIA) | $8K | — | $8K | 0.08% |
| HEWITT INSURANCE BROKERAGE LLC3 Filed as: HEWITT INSURANCE BROKERAGE | 39030 TREASURY CENTER CHICAGO, IL 60694 | KAISER FOUNDATION HEALTH PLAN OF MID-ATLANTIC STATES, INC. | $73K | — | $73K | 0.90% |
| CHARLES NELSON3 | P.O. BOX 639 WILMETTE, IL 60091 | KAISER FOUNDATION HEALTH PLAN OF MID-ATLANTIC STATES, INC. | $5K | $31K | $36K | 0.44% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. | 29840 NETWORK PLACE CHICAGO, IL 60673 | ANTHEM HEALTHKEEPERS | $40K | — | $40K | 0.83% |
| CHARLES NELSON3 | PO BOX 639 WILMETTE, IL 60091 | ANTHEM HEALTHKEEPERS | $4K | — | $4K | 0.09% |
| AON CONSULTING INC3 Filed as: AON CONSULTING INC. | 29840 NETWORK PLACE CHICAGO, IL 60673 | MINNESOTA LIFE INSURANCE COMPANY-OPTIONAL | — | $88K | $88K | 2.22% |
| AON CONSULTING INC3 Filed as: AON HEWITT | 8182 MARYLAND AVE. SUITE 1500 ST. LOUIS, MO 63105 | MINNESOTA LIFE INSURANCE COMPANY-OPTIONAL | — | $4K | $4K | 0.10% |
| AON CONSULTING INC3 | 29840 NETWORK PLACE CHICAGO, IL 60673 | MINNESOTA LIFE INSURANCE COMPANY-BASIC | — | $27K | $27K | 2.22% |
| AON CONSULTING INC3 Filed as: AON HEWITT | 8182 MARYLAND AVE. SUITE 1500 ST. LOUIS, MO 63105 | MINNESOTA LIFE INSURANCE COMPANY-BASIC | — | $1K | $1K | 0.10% |
| AON CONSULTING INC3 Filed as: AON CONSULTING, INC. - IL | PO BOX 905494 CHARLOTTE, NC 28290 | KAISER FOUNDATION HEALTH PLAN, INC. (CALIFORNIA) | $11K | — | $11K | 1.87% |
| CHARLES NELSON3 | PO BOX 639 WILMETTE, IL 600910639 | KAISER FOUNDATION HEALTH PLAN, INC. (CALIFORNIA) | -$5K | — | -$5K | -0.76% |
| PLAZA FINANCIAL SERVICES CO3 | 5260 WESTERN AVENUE CHEVY CHASE, MD 20815 | JOHN HANCOCK LIFE INSURANCE COMPANY | $22K | — | $22K | 5.00% |
| CHARLES R IEUTER3 Filed as: CHARLES SPENCER NELSON | PO BOX 639 WILMETTE, IL 60091 | KAISER FOUNDATION HEALTH PLAN, INC. | $4K | — | $4K | 0.94% |
| AMERICAN BENEFIT SERVICES, INC.3 | P O BOX 639 WILMETTE, IL 60091 | HAWAII DENTAL SERVICE | $2K | — | $2K | 1.57% |
| PLAZA FINANCIAL SERVICES CO3 | 5260 WESTERN AVE CHEVY CHASE, MD 20815 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | — | $0 | — |
| DELTA DENTAL3 | ONE DELTA DRIVE MECHANICSBURG, PA 17055 | DELTA DENTAL | — | $659K | $659K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICE LLC EIN 47-0854646 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | — | $13.1M |
| CAREMARK EIN 75-2882129 ADMINISTRATIVE | Contract Administrator Service code 13 | — | $127K |
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 | 34,812 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 704 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 35,516 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | HAWAII DENTAL SERVICE | 61,565 | $126K |
| Vision(2 contracts, 2 carriers) | EYEMED VISION CARE | 49,986 | $2.3M |
| Life insurance(2 contracts, 2 carriers) | MINNESOTA LIFE INSURANCE COMPANY-OPTIONAL | 37,038 | $5.2M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 35,516 | $4.5M |
| Other(5 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN,INC. (CALIFORNIA) | 2,280 | $10.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 61,565 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.