| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF FLORIDA3 Filed as: BLUE CROSS AND BLUE SHIELD OF LOUIS | 5525 REITZ AVE BATON ROUGE, LA 708093802 | BLUE CROSS AND BLUE SHIELD OF LOUISIANA | — | $684K | $684K | 18.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON US | 200 LIBERTY STREET FI6 NEW YORK, NY 10281 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $342K | $27K | $368K | 23.31% |
| WILLIS TOWERS WATSON US LLC3 | 500 NORTH AKARD DALLAS, TX 75201 | HCC LIFE INSURANCE COMPANY | $21K | — | $21K | 2.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON US | 200 LIBERTY STREET FI6 NEW YORK, NY 10281 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $75K | $6K | $81K | 23.33% |
| VISION SERVICE PLAN3 | 3333 QUALITY DRIVE MS-163 RANCHO CORDOVA, CA 95670 | VISION SERVICE PLAN | — | $36K | $36K | 12.25% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 100878852 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 20.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON US | PO BOX 101162 PASADENA, CA 911890001 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $135 | — | $135 | 2.20% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $87 | $87 | 1.42% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD-SC EIN 57-0287419 INSURANCE PROVIDER/ADM | Insurance services Service code 23 | I-20 EAST AT ALPINE RD COLUMBIA, SC 29219 | $796K |
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 | 1,883 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 271 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 170 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,324 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF LOUISIANA | 1,500 | $3.8M |
| Dental | BLUE CROSS AND BLUE SHIELD OF LOUISIANA | 1,500 | $3.8M |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 1,196 | $330K |
| Life insurance | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 1,883 | $1.6M |
| Long-term disability | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 1,159 | $346K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF LOUISIANA | 1,500 | $3.8M |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 1,221 | $1.1M |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 402 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,883 | — |
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.