| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE,INC | 335 MADISON AVE FL 20 NEW YORK, NY 100174633 | RELIASTAR LIFE INSURANCE COMPANY | — | $87K | $87K | 5.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE, INC. | COMMISSION LOCKBOX 28852 P.O. BOX 28852 NEW YORK, NY 10087 | HYATT LEGAL PLANS, INC. | $37K | — | $37K | 9.99% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON PENNSYLVANIA, INC | P.O. BOX 9102 PHILADELPHIA, PA 191788500 | HYATT LEGAL PLANS, INC. | — | $95 | $95 | 0.03% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE, INC. | D/B/A WATSON WYATT WORLDWIDE, INC. LOCKBOX #741909, P.O. BOX 741909 ATLANTA, GA 303741909 | HYATT LEGAL PLANS, INC. | — | — | $0 | 0.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH &BENEFIT LLC | 1166 AVE OF AMERICAS 22F NEW YORK, NY 10036 | FEDERAL INSURANCE COMPANY | $19K | — | $19K | 25.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 06-0303370 CLAIMS ADMIN | Named fiduciary; Direct payment from the plan; Contract Administrator; Non-monetary compensation; Claims processing; Float revenue; Other services; Participant communication Service code 12 | — | $803K |
| REDBRICK HEALTH EIN 20-5250594 SERVICE PROVIDER | Other fees Service code 99 | — | $543K |
| ANTHEM BLUE CROSS LIFE AND HEALTH EIN 95-4331852 CONTRACT ADMIN | Float revenue; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Contract Administrator Service code 12 | — | $373K |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $238K |
| MATRIX ABSENCE MANAGEMENT, INC EIN 77-0493584 NONE | Claims processing Service code 12 | — | $218K |
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 | 7,613 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 7,613 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTHCARE OF CALIFORNIA | 2,397 | $10.9M |
| Dental | CONNECTICUT GERNEAL LIFE INSURANCE COMPANY | 1,374 | $276K |
| Vision | VISION SERVICE PLAN | 6,007 | $1.3M |
| Life insurance | STANDARD INSURANCE COMPANY | 7,092 | $3.4M |
| Long-term disability | STANDARD INSURANCE COMPANY | 7,098 | $3.0M |
| Other(6 contracts, 6 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 7,613 | $2.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 7,613 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.