| 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 | $283K | $16K | $299K | 3.35% |
| WILLIS TOWERS WATSON US LLC3 | 500 NORTH AKARD STREET DALLAS, TX 75201 | ZURICH AMERICAN INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HCSC-BLUE CROSS BLUE SHIELD OF TEXA EIN 36-1236610 NONE | Claims processing; Contract Administrator; Insurance services; Direct payment from the plan Service code 12 | — | $5.6M |
| FIDELITY EIN 04-2507163 NONE | Recordkeeping fees; Direct payment from the plan Service code 50 | — | $1.9M |
| TEXAS INSTRUMENTS INCORPORATED EIN 75-0289970 PLAN SPONSOR | Plan Administrator; Direct payment from the plan Service code 14 | — | $658K |
| DELTA DENTAL INSURANCE COMPANY EIN 94-2761537 NONE | Direct payment from the plan; Claims processing; Contract Administrator; Insurance services Service code 12 | — | $584K |
| CAREMARK, LLC EIN 05-0340626 NONE | Direct payment from the plan; Claims processing; Insurance services; Contract Administrator Service code 12 | — | $515K |
| MAGELLAN BEHAVIORAL CORPORATION EIN 52-2135463 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $207K |
| ERNST & YOUNG LLP EIN 34-6565596 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $140K |
| NORTHERN TRUST COMPANY EIN 36-1561860 TRUSTEE | Trustee (bank, trust company, or similar financial institution); Direct payment from the plan Service code 21 | — | $20K |
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 | 14,285 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 176 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 14,461 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 146 | $1.5M |
| Dental | AETNA LIFE INSURANCE CO. | 2,074 | $426K |
| Vision | VISION SERVICE PLAN | 9,429 | $2.3M |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 27,327 | $8.9M |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 27,327 | $9.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 27,327 | — |
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.