| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 100878852 | METROPOLITAN LIFE INSURANCE COMPANY | $264K | $16K | $279K | 3.62% |
| WILLIS TOWERS WATSON US LLC3 | 500 NORTH AKARD STREET SUITE 4100 DALLAS, TX 752013302 | ZURICH AMERICAN INSURANCE COMPANY | $2K | — | $2K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HCSC-BLUE CROSS BLUE SHIELD OF TEXA EIN 36-1236610 NONE | Insurance services; Direct payment from the plan; Contract Administrator; Claims processing Service code 12 | — | $4.4M |
| FIDELITY EIN 04-2507163 NONE | Recordkeeping fees; Direct payment from the plan Service code 50 | — | $1.4M |
| TEXAS INSTRUMENTS INCORPORATED EIN 75-0289970 PLAN SPONSOR | Direct payment from the plan; Plan Administrator Service code 14 | — | $525K |
| DELTA DENTAL INSURANCE COMPANY EIN 94-2761537 NONE | Contract Administrator; Insurance services; Direct payment from the plan; Claims processing Service code 12 | — | $487K |
| CAREMARK, LLC EIN 05-0340626 NONE | Claims processing; Direct payment from the plan; Contract Administrator; Insurance services Service code 12 | — | $354K |
| MAGELLAN BEHAVIORAL CORPORATION EIN 52-2135463 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $177K |
| ERNST & YOUNG LLP EIN 34-6565596 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $137K |
| WILLIS TOWERS WATSON US LLC EIN 53-0181291 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $129K |
| NORTHERN TRUST COMPANY EIN 36-1561860 TRUSTEE | Trustee (bank, trust company, or similar financial institution); Direct payment from the plan Service code 21 | — | $18K |
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 | 12,670 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 248 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 12,918 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 180 | $1.1M |
| Dental | AETNA LIFE INSURANCE CO. | 1,666 | $392K |
| Vision | VISION SERVICE PLAN | 8,603 | $2.0M |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 25,868 | $7.7M |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 46,500 | $8.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 46,500 | — |
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.