| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | $66K | — | $66K | 8.48% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: THE L WARNER COMPANIES INC. | 9690 DEERECO RD SUITE 650 TIMONIUM, MD 21093 | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | $12K | — | $12K | 1.52% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE, INC. | PO BOX 28852 NEW YORK, NY 100878852 | SELECTHEALTH | $21K | — | $21K | 3.22% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | COM LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | SECURIAN LIFE INSURANCE COMPANY | $87K | $10K | $97K | 21.17% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | COM LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | MINNESOTA LIFE INSURANCE COMPANY | $59K | $8K | $68K | 21.49% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWER WATSON DELAWARE | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | $33K | — | $33K | 18.39% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: THE L WARNER COMPANIES INC. | 9690 DEERECO RD SUITE 650 TIMONIUM, MD 21093 | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 1.61% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | 901 N. GLEBE ROAD ARLINGTON, VA 22203 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $21K | — | $21K | 20.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $6K | — | $6K | 9.14% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: THE L WARNER COMPANIES INC. | 9690 DEERECO RD SUITE 650 TIMONIUM, MD 21093 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $555 | — | $555 | 0.86% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | 901 N. GLEBE ROAD ARLINGTON, VA 22203 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $9K | — | $9K | 20.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON | 901 N. GLEBE ROAD ARLINGTON, VA 22203 | NATIONAL UNION FIRE INS CO. OF PITTSBURGH, PA | $8K | — | $8K | 20.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE INSURANCE COMPANY EIN 47-0854646 NONE | Claims processing; Other services Service code 12 | — | $2.9M |
| DELTA DENTAL EIN 54-0844477 NONE | Contract Administrator Service code 13 | — | $147K |
| CIGNA BEHAVIORAL HEALTH, INC. EIN 41-1648670 NONE | Direct payment from the plan; Contract Administrator; Claims processing; Participant communication Service code 12 | — | $109K |
| TOWERS WATSON EIN 53-0181291 NONE | Other commissions Service code 55 | — | $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 | 7,221 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 7,221 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 7,534 | $5.7M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 9,866 | $301K |
| Life insurance(2 contracts, 2 carriers) | SECURIAN LIFE INSURANCE COMPANY | 8,589 | $771K |
| Short-term disability | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | 5,374 | $783K |
| Long-term disability | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,107 | $178K |
| Other(4 contracts, 2 carriers) | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | 6,957 | $254K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 9,866 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.