| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CORESOURCE, INC.3 Filed as: CORESOURCE | 62707 COLLECTION CENTER DR. CHICAGO, IL 606930001 | VISION SERVICE PLAN | $66K | — | $66K | 10.39% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINA BEACH, VA 23466 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $54K | $15K | $69K | 12.68% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TRUSTMARK HEALTH BENEFITS, INC. EIN 35-1846036 NONE | Other services; Plan Administrator; Claims processing Service code 12 | — | $3.5M |
| AETNA - PPO EIN 06-6033492 NONE | Other services; Claims processing Service code 12 | — | $984K |
| VISION SERVICE PLAN EIN 06-1227840 NONE | Other services; Claims processing Service code 12 | — | $858K |
| MULTIPLAN EIN 43-6004435 NONE | Plan Administrator; Other services; Claims processing Service code 12 | — | $200K |
| CHANGE HEALTHCARE EIN 20-5716594 NONE | Claims processing; Other services Service code 12 | — | $147K |
| TELADOC EIN 04-3705970 NONE | Claims processing; Plan Administrator; Other services Service code 12 | — | $142K |
| ACS - A XEROX COMPANY EIN 36-4129784 NONE | Other services; Claims processing Service code 12 | — | $83K |
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 | 8,826 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 8,826 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN, INC | 425 | $4.4M |
| Vision | VISION SERVICE PLAN | 4,804 | $638K |
| Life insurance | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 8,975 | $542K |
| Stop-loss / reinsurancereinsurance | AETNA LIFE INSURANCE COMPANY | 8,214 | $851K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 8,975 | — |
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.