| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 | COM LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | SECURIAN LIFE INSURANCE COMPANY | $187K | $23K | $210K | 21.65% |
| 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 | $95K | $8K | $102K | 10.81% |
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | $55K | $2K | $57K | 20.71% |
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $14K | $1K | $15K | 10.75% |
| WILLIS TOWERS WATSON US LLC3 | 901 N. GLEBE ROAD ARLINGTON, VA 22203 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | — | $28K | $28K | 20.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON US LLC | 901 N. GLEBE ROAD ARLINGTON, VA 22203 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | — | $19K | $19K | 20.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON US LLC | 901 N. GLEBE ROAD ARLINGTON, VA 22203 | NATIONAL UNION FIRE INS CO. OF PITTSBURGH, PA | — | $13K | $13K | 20.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM EIN 54-0357120 NONE | Claims processing; Other services; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue Service code 12 | — | $1.4M |
| AETNA EIN 06-6033492 NONE | Contract Administrator Service code 13 | — | $1.1M |
| DELTA DENTAL OF VIRGINIA EIN 54-0844477 NONE | Contract Administrator Service code 13 | — | $205K |
| CIGNA BEHAVIORAL HEALTH, INC. EIN 41-1648670 NONE | Contract Administrator; Direct payment from the plan; Claims processing; Participant communication Service code 12 | — | $123K |
| HEALTHKEEPERS, INC. (G1608) EIN 54-1356687 NONE | Contract Administrator; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Float revenue Service code 12 | — | $1K |
| CIGNA | Other services; Float revenue; Direct payment from the plan; Contract Administrator; Participant communication; Named fiduciary; Claims processing; Non-monetary compensation Service code 12 | — | $0 |
| CIGNA HEALTH AND LIFE INSURANCE EIN 59-1031071 NONE | Non-monetary compensation; Claims processing; Participant communication; Contract Administrator; Named fiduciary; Direct payment from the plan; Other services; Float revenue Service code 12 | — | $0 |
| HEALTHEQUITY EIN 52-2383166 NONE | Claims processing; Participant communication; Contract Administrator; Named fiduciary; Direct payment from the plan; Other services Service code 12 | — | $0 |
| WILLIS TOWERS WATSON US LLC EIN 54-0357120 NONE | Insurance brokerage commissions and fees; Insurance agents and brokers; Other commissions Service code 22 | — | $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 | 9,371 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 9,371 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 4,655 | $4.6M |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 4,314 | $406K |
| Life insurance | SECURIAN LIFE INSURANCE COMPANY | 10,551 | $969K |
| Short-term disability | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | 385 | $947K |
| Long-term disability | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | 697 | $275K |
| Other(5 contracts, 3 carriers) | CIGNA LIFE INSURANCE CO. OF NEW YORK | 9,762 | $462K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 10,551 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.