| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY AND ASSOCIATES | 12712 PARK CENTRAL DRIVE SUITE 100 DALLAS, TX 75251 | VISION SERVICE PLAN | $19K | — | $19K | 0.10% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY AND ASSOCIATES | 12712 PARK CENTRAL DRIVE SUITE 100 DALLAS, TX 75251 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $273K | $53K | $326K | 3.22% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY AND ASSOCIATES | 12712 PARK CENTRAL DRIVE SUITE 100 DALLAS, TX 75251 | KAISER FOUNDATION HEALTH PLAN, INC. | $212K | — | $212K | 2.76% |
| RUEBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | HARTFORD LIFE AND ACCIDENT | — | $38K | $38K | 17.00% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES, MURPHY & ASSOCIATES | 12712 PARK CENTRAL DRIVE DALLAS, TX 75251 | HARTFORD LIFE AND ACCIDENT | $22K | — | $22K | 10.00% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY AND ASSOCIATES | 12712 PARK CENTRAL DRIVE SUITE 100 DALLAS, TX 75251 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $5K | $2K | $7K | 7.23% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY AND ASSOCIATES | 12712 PARK CENTRAL DRIVE SUITE 100 DALLAS, TX 75251 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $1K | — | $1K | 3.59% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF TEXAS EIN 36-1236610 CLAIMS ADMINISTRATOR | Contract Administrator Service code 13 | — | $6.0M |
| CIGNA BEHAVIORAL HEALTH, INC. EIN 41-1648670 CONTRACT ADMINISTRATOR | Claims processing; Participant communication; Contract Administrator; Direct payment from the plan Service code 12 | — | $342K |
| CVS PHARMACY, INC. EIN 05-0340626 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $120K |
| BANK OF AMER HLTH BENEFIT SOLUTIONS CONTRACT ADMINISTRATOR | Claims processing Service code 12 | P.O. BOX 2931 MILWAUKEE, WI 53201 | $104K |
| METROPOLITAN LIFE INS. CO. EIN 13-5581829 CLAIMS ADMINISTRATOR | Contract Administrator Service code 13 | — | $49K |
| CIGNA BEHAVIORAL HEALTH | Direct payment from the plan; Claims processing; Contract Administrator; Participant communication Service code 12 | — | $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 | 20,730 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 82 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 20,812 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 4,188 | $7.8M |
| Vision | VISION SERVICE PLAN | 14,664 | $18.7M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 20,730 | $10.1M |
| Short-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 20,730 | $10.2M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 20,730 | $10.1M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 20,730 | $10.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 20,730 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.