| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERITAIN HEALTH3 Filed as: AETNA LIFE INSURANCE COMPANY | 151 FARMINGTON AVE HARTFORD, CT 06156 | AETNA LIFE INSURANCE COMPANY | $10K | — | $10K | 0.10% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | PO BOX 13784 NEWARK, NJ 071883784 | METROPOLITAN LIFE INSURANCE COMPANY | $69K | — | $69K | 5.76% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE, INC | 26 CENTURY BLVD C/O JP MORGAN CHASE NASHVILLE, TN 372143685 | METROPOLITAN LIFE INSURANCE COMPANY | — | $20K | $20K | 1.65% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHWEST INC | PO BOX 13784 NEWARK, NJ 071880001 | METROPOLITAN LIFE INSURANCE COMPANY | $355 | $28 | $383 | 0.03% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHWAST, INC | PO BOX 13784 NEWARK, NJ 071880001 | METROPOLITAN LIFE INSURANCE COMPANY | $186 | $28 | $214 | 0.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE INC | 28 CENTURY BLVD C/O JP MORGAN CHASE NASHVILLE, TN 372143685 | METROPOLITAN LIFE INSURANCE COMPANY | — | $93 | $93 | 0.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE, INC | 26 CENTURY BLVD C/O JP MORGAN CHASE NASHVILLE, TN 372143685 | METROPOLITAN LIFE INSURANCE COMPANY | $14 | $32 | $46 | 0.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE INC | 28 CENTURY BLVD C/O JP MORGAN CHASE NASHVILLE, TN 372143685 | METROPOLITAN LIFE INSURANCE COMPANY | — | $43 | $43 | 0.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHWEST, INC | PO BOX 13784 NEWARK, NJ 08807 | METROPOLITAN LIFE INSURANCE COMPANY | $14 | $28 | $42 | 0.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHWEST INC | PO BOX 13784 NEWARK, NJ 071880001 | METROPOLITAN LIFE INSURANCE COMPANY | — | $28 | $28 | 0.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MARYLAND, INC | PO BOX 13784 NEWARK, NJ 071880001 | METROPOLITAN LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MARYLAND, INC | PO BOX 13784 NEWARK, NJ 071880001 | METROPOLITAN LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MARYLAND INC | 12505 PARK POTOMA AVE SUITE 7 POTPMAC, MD 20854 | CIGNA HEALTH & LIFE INSURANCE COMPANY | $50K | — | $50K | 9.48% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 12505 PARK POTOMAC AVENUE 300 POTOMAC, MD 20854 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $9K | — | $9K | 4.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MARYLAND, INC | P O BOX 13784 NEWARK, NJ 07188 | VISION SERVICE PLAN | $8K | — | $8K | 4.83% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 12505 PARK POTOMAC AVENUE 300 POTOMAC, MD 20854 | CIGNA HEALTH & LIFE INSURANCE COMPANY | $6K | — | $6K | 7.64% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MARYLAND INC | P O BOX 13784 NEWARK, NJ 07188 | CIGNA HEALTH & LIFE INSURANCE COMPANY | $16 | — | $16 | 0.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | PO BOX 13784 NEWARK, NJ 071880001 | HARTFORD ACCIDENT AND LIFE INSURANCE CO | — | $1K | $1K | 6.11% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATION | Contract Administrator Service code 13 | 151 FARMINGTON AVENUE RSAA HARTFORD, CT 06156 | $534K |
| UPMC BENEFIT MANAGEMENT SERVICES EIN 25-1769564 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 600 GRANT STREET PITTSBURGH, PA 15219 | $458K |
| CBIZ BENEFITS & INSURANCE SERVICES EIN 31-1582098 ADMIN SUPPORT SERVICES | Direct payment from the plan; Plan Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 14 | 175 S MAIN STREET SUITE 720 SALT LAKE CITY, UT 84111 | $216K |
| FRYE & COMPANY, CPAS EIN 45-4199441 PLAN AUDITOR | Accounting (including auditing) Service code 10 | 9161 LIBERIA AVENUE SUITE 304 MANASSAS, VA 20110 | $34K |
| AETNA BEHAVIORAL HEALTH, LLC EIN 06-6033492 CONTRACT ADMINISTRATION | Contract Administrator Service code 13 | 151 FARMINGTON AVE HARTFORD, CT 06156 | $22K |
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIMS PROCESSING | Float revenue; Claims processing; Named fiduciary; Participant communication; Other services; Non-monetary compensation; Direct payment from the plan; Contract Administrator Service code 12 | 111 S CALVERT ST SUITE 1600 BALTIMORE, MD 21202 | $0 |
| HEATLH & HUMAN RESOURCES CENTER INC EIN 06-6033492 CONTRACT ADMINISTRATION | Contract Administrator Service code 13 | 151 FARMINGTON AVE HARTFORD, CT 06156 | $0 |
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 CLAIMS PROCESSING | Contract Administrator Service code 13 | 501 US HIGHWAY 22 2ND FLOOR-WEST BRIDGEWATER, NJ 08807 | $0 |
| UPMC BENEFIT MANAGEMENT EIN 25-1769564 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 600 GRANT STREET PITTSBURGH, PA 15219 | $0 |
| VISION SERVICE PLAN EIN 23-7089668 CLAIMS PROCESSING | Named fiduciary; Participant communication; Other services; Non-monetary compensation; Contract Administrator; Direct payment from the plan; Float revenue; Claims processing Service code 12 | 3333 QUALITY DR RANCHO CORDOVA, CA 95670 | $0 |
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 | 1,885 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,885 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(7 contracts, 5 carriers) | CIGNA HEALTH & LIFE INSURANCE COMPANY | 41 | $1.0M |
| Dental(5 contracts, 4 carriers) | CIGNA HEALTH & LIFE INSURANCE COMPANY | 785 | $1.1M |
| Vision(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 1,293 | $641K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 2,669 | $1.2M |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 2,669 | $1.2M |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 2,669 | $1.2M |
| Prescription drug | USABLE MUTUAL INSURANCE COMPANY | 0 | $0 |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 2,567 | $9.4M |
| Other(7 contracts, 6 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,669 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,669 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.