| 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 | — | $313K | $313K | 2.34% |
| 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 | — | $39K | $39K | 0.76% |
| 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 | 0.84% |
| 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 | — | $2 | $2 | 0.45% |
| 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 | — | $1 | $1 | 0.41% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTH CARE SERVICE CORPORATION EIN 36-1236610 NONE | Contract Administrator; Claims processing Service code 12 | — | $8.5M |
| EXPRESS SCRIPTS, INC. EIN 22-3461740 NONE | Contract Administrator; Claims processing Service code 12 | — | $1.3M |
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 NONE | Other services; Named fiduciary; Float revenue; Claims processing; Participant communication; Contract Administrator; Direct payment from the plan; Non-monetary compensation Service code 12 | — | $1.2M |
| BEACON HEALTH OPTIONS, INC. EIN 54-1414194 NONE | Insurance services Service code 23 | — | $717K |
| TOWERS PERRIN FORSTER & CROSBY INC. EIN 53-0181291 NONE | Consulting (general) Service code 16 | — | $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 | 23,634 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 411 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 24,045 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 3,799 | $414K |
| Vision | VISION SERVICE PLAN | 18,929 | $3.9M |
| Life insurance | MINNESOTA LIFE INSURANCE COMPANY | 33,776 | $13.3M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 23,591 | $5.1M |
| Other(5 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 40,368 | $3.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 40,368 | — |
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.