| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $156K | — | $156K | 1.42% |
| FRED MAXWELL - ACIUS GROUP3 Filed as: FRED THOMAS MAXWELL II | 2591 DALLAS PKWY STE 203 FRISCO, TX 75034 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $30K | $18K | $48K | 0.44% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $183K | — | $183K | 20.12% |
| FRED MAXWELL - ACIUS GROUP3 Filed as: FRED THOMAS MAXWELL II | 2591 DALLAS PARKWAY, SUITE STE 203 FRISCO, TX 75034 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $15K | $15K | 1.67% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE INSURANCE CO EIN 36-2739571 NONE | Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $4.4M |
| EXPRESS SCRIPTS INC. EIN 22-3461740 NONE | Contract Administrator; Direct payment from the plan; Claims processing Service code 12 | — | $639K |
| VISION SERVICE PLAN EIN 94-1632821 NONE | Direct payment from the plan; Contract Administrator; Claims processing Service code 12 | — | $86K |
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 | 6,267 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3,481 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 14 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 9,762 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $11.0M |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $11.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 0 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.