| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| 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 | $14K | $520 | $15K | 4.08% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MARYLAND | 12505 PARK POTOMAC AVE STE 300 POTOMAC, MD 20874 | CIGNA HEALTH & LIFE INSURANCE COMPANY | $26K | — | $26K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MARYLAND | P O BOX 13784 NEWARK, NJ 07188 | UPMC HEALTH BENEFITS | $20K | — | $20K | 10.30% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MARYLAND, INC | P O BOX 13784 NEWARK, NJ 07188 | VISION SERVICE PLAN | $6K | — | $6K | 4.52% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MARYLAND, INC | 12505 PARK POTOMA AVE SUITE 7 POTOMAC, MD 20874 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $11K | — | $11K | 35.51% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWER WATSON US LLC | LOCKBOX 28852 PO BOX 28852 POTPMAC, MD 20854 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | — | $649 | $649 | 2.08% |
| THOMAS C SMITH3 | 2928 FOSTER CREIGHTON DR NASHVILLE, TN 37204 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $176 | — | $176 | 0.56% |
| ASHLEY L. DEMATTEO3 Filed as: ASHLEY DEMATTEO | 2928 FOSTER CREIGHTON DR NASHVILLE, TN 37204 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MARYLAND INC | P O BOX 13784 NEWARK, NJ 07188 | CIGNA HEALTH & LIFE INSURANCE COMPANY | $2K | — | $2K | 7.86% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MARYLAND INC | 12505 PARK POTOMA AVE POTOMAC, MD 20854 | MONUMENTAL LIFE INSURANCE COMPANY | $1K | — | $1K | 5.60% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATION | Contract Administrator Service code 13 | 155 FARMINGTON AVENUE RSAA HARTFORD, CT 06156 | $421K |
| CBIZ BENEFITS & INSURANCE SERVICES EIN 31-1582098 ADMIN SUPPORT SERVICES | Recordkeeping and information management (computing, tabulating, data processing, etc.); Plan Administrator; Direct payment from the plan Service code 14 | 175 S MAIN STREET SUITE 720 SALT LAKE CITY, UT 84111 | $261K |
| UPMC BENEFIT MANAGEMENT EIN 25-1769564 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 600 GRANT STREET PITTSBURGH, PA 15219 | $56K |
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIMS PROCESSING | Direct payment from the plan; Named fiduciary; Claims processing; Other services; Participant communication; Float revenue; Non-monetary compensation; Contract Administrator Service code 12 | 111 S CALVERT ST SUITE 1600 BALTIMORE, MD 21202 | $49K |
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 CLAIMS PROCESSING | Contract Administrator; Claims processing Service code 12 | 501 US HIGHWAY 22 2ND FLOOR-WEST BRIDGEWATER, NJ 08807 | $23K |
| FRYE & COMPANY, CPAS EIN 45-4199441 PLAN AUDITOR | Accounting (including auditing) Service code 10 | 9161 LIBERIA AVENUE SUITE 304 MANASSAS, VA 20110 | $21K |
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 | 2,383 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 2,383 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 5 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | 477 | $1.0M |
| Dental(5 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | 264 | $875K |
| Vision(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | 1,329 | $697K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 2,727 | $1.3M |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 2,727 | $1.3M |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 2,727 | $1.3M |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 768 | $729K |
| Other(4 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,727 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,727 | — |
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.