| 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 | $223K | $36K | $259K | 1.98% |
| 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 | $217K | $7K | $223K | 23.49% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INS. CO. EIN 59-1031071 NONE | Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $2.3M |
| MEDCO HEALTH SOLUTIONS EIN 22-3461740 NONE | Direct payment from the plan; Contract Administrator; Claims processing Service code 12 | — | $638K |
| FIDELITY INVESTMENTS EIN 04-2647786 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $205K |
| VISION SERVICE PLAN EIN 94-1632821 NONE | Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $95K |
| NISA INVESTMENT ADVISORS LLC EIN 48-1140940 NONE | Investment management; Direct payment from the plan Service code 28 | — | $91K |
| BNY MELLON ASSET MGMT NORTH AMERICA EIN 25-1442864 NONE | Investment management; Redemption fees Service code 28 | — | $50K |
| STATE STREET BANK & TRUST CO. EIN 81-6137331 NONE | Investment management fees paid directly by plan Service code 51 | — | $29K |
| TOWERS WATSON DELAWARE, INC. EIN 53-0181291 NONE | Direct payment from the plan; Actuarial; Consulting (pension) Service code 11 | — | $12K |
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 | 6,276 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3,991 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 16 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 10,283 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $13.1M |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $14.0M |
| 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.