| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON US | 200 LIBERTY ST F16 NEW YORK, NY 10281 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | — | $70K | $70K | 1.36% |
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 P.O. BOX 28852 NEW YORK, NY 10087 | METLIFE LEGAL PLANS | — | $8K | $8K | 17.04% |
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 P.O. BOX 28852 NEW YORK, NY 10087 | METLIFE LEGAL PLANS | $5K | — | $5K | 9.97% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS LIFE AND HEALTH EIN 95-4331852 CONTRACT ADMIN | Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Other services Service code 12 | — | $5.4M |
| LYRA HEALTH, INC. EIN 47-2935919 NONE | Direct payment from the plan; Other services Service code 49 | — | $1.6M |
| CIGNA EIN 06-0303370 CLAIMS ADMIN | Other services; Named fiduciary; Direct payment from the plan; Contract Administrator; Claims processing; Non-monetary compensation; Float revenue; Participant communication Service code 12 | — | $424K |
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $371K |
| MATRIX ABSENCE MANAGEMENT, INC EIN 77-0493584 NONE | Claims processing Service code 12 | — | $219K |
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 | 8,846 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 8,846 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTHCARE OF CALIFORNIA | 1,777 | $9.6M |
| Dental | CONNECTICUT GERNEAL LIFE INSURANCE COMPANY | 1,207 | $257K |
| Vision | VISION SERVICE PLAN | 6,619 | $1.6M |
| Life insurance | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 8,004 | $5.2M |
| Short-term disability | FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY | 310 | $145K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 7,949 | $3.3M |
| Other(4 contracts, 4 carriers) | CONNECTICUT GERNEAL LIFE INSURANCE COMPANY | 8,846 | $448K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 8,846 | — |
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.