| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES 785439 | 6550 ROCK SPRING DR SUITE 610 BETHESDA, MD 20817 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $78K | — | $78K | 8.19% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON US L | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $17K | — | $17K | 1.81% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1125 SANCTUARY PARKWAY SUITE 300 ALPHARETTA, GA 30009 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $21K | — | $21K | 8.28% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON US L | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $4K | — | $4K | 1.72% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES 785439 | 6550 ROCK SPRING DR SUITE 610 BATHESDA, MD 20817 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $29K | — | $29K | 15.69% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON US L | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | — | $8K | 4.31% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1125 SANCTUARY PARKWAY SUITE 300 ALPHARETTA, GA 30009 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $11K | — | $11K | 10.00% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1125 SANCTUARY PARKWAY SUITE 300 ALPHARETTA, GA 30009 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $6K | — | $6K | 10.00% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1125 SANCTUARY PARKWAY SUITE 300 ALPHARETTA, GA 30009 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $5K | — | $5K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF VIRGINIA, IN EIN 54-0357120 CONTRACT ADMINISTRATOR | Float revenue; Insurance agents and brokers; Contract Administrator; Other commissions; Claims processing; Non-monetary compensation; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $3.4M |
| EXPRESS SCRIPTS, INC. EIN 43-1420563 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $475K |
| DELTA DENTAL OF VIRGINA EIN 54-0844477 BENEFIT ADMINISTRATOR | Contract Administrator Service code 13 | — | $235K |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVE. HARTFORD, CT 06156 | $129K |
| WAGEWORKS FEDERAL EIN 94-3351864 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $23K |
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 | 12,988 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 140 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 13,128 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 8,599 | $4.0M |
| Short-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 6,896 | $1.2M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,188 | $186K |
| Other(4 contracts, 2 carriers) | ANTHEM HEALTH PLANS OF VIRGINIA, INC. | 9,370 | $340K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 9,370 | — |
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."
No prospect flags tripped on this filing.