| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE, INC. | PO BOX 305025 NASHVILLE, TN 37230 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $10K | $10K | 0.26% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CVS PHARMACY, INC. EIN 05-0340626 CONTRACT ADMINISTRATOR | Insurance services; Contract Administrator; Investment management fees paid indirectly by plan; Investment management fees paid directly by plan; Claims processing Service code 12 | — | $9.0M |
| INSURANCE MANAGEMENT SERVICES EIN 75-2355889 TPA | Recordkeeping and information management (computing, tabulating, data processing, etc.); Plan Administrator; Claims processing Service code 12 | — | $484K |
| DELTA DENTAL OF TENNESSEE EIN 62-0812197 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $191K |
| VISION SERVICE PLAN EIN 06-1227840 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $65K |
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 | 13,764 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 59 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 13,823 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HM LIFE INSURANCE COMPANY | 2,265 | $445K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 12,855 | $3.8M |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 12,855 | $3.8M |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 12,855 | $3.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 12,855 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.