| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | COM LOCKBOX 28852 PO BOX 28852 US NEW YORK, NY 100878852 | MINNESOTA LIFE INSURANCE COMPANY | — | $339K | $339K | 2.38% |
| WILLIS TOWERS WATSON US LLC7 Filed as: TOWERS WATSON DELAWARE IN | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $30K | $30K | 0.57% |
| WILLIS TOWERS WATSON US LLC7 Filed as: TOWERS WATSON DELAWARE IN | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $4K | $4K | 0.69% |
| WILLIS TOWERS WATSON US LLC7 Filed as: TOWERS WATSON DELAWARE IN | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $5 | $5 | 2.26% |
| WILLIS TOWERS WATSON US LLC7 Filed as: TOWERS WATSON DELAWARE IN | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | CIGNA LIFE INSURANCE CO. OF NEW YORK | — | $2 | $2 | 2.44% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH CARE SERVICE CORPORATION EIN 36-1236610 NONE | Claims processing; Contract Administrator Service code 12 | — | $7.4M |
| EXPRESS SCRIPTS, INC. EIN 22-3461740 NONE | Claims processing; Contract Administrator Service code 12 | — | $1.3M |
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 NONE | Contract Administrator; Claims processing Service code 12 | — | $1.1M |
| VALUEOPTIONS, INC EIN 54-1414194 NONE | Contract Administrator; Claims processing Service code 12 | — | $679K |
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 | 18,598 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 756 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 19,354 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 2,031 | $270K |
| Vision | VISION SERVICE PLAN | 15,249 | $3.7M |
| Life insurance | MINNESOTA LIFE INSURANCE COMPANY | 27,187 | $14.3M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 18,598 | $5.3M |
| Other(5 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 18,598 | $3.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 27,187 | — |
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.