| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC4 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $231K | $67K | $298K | 2.19% |
| WILLIS TOWERS WATSON US LLC4 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $233K | $5K | $238K | 24.79% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INS. CO. EIN 59-1031071 NONE | Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | — | $2.1M |
| MEDCO HEALTH SOLUTIONS EIN 22-3461740 NONE | Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $623K |
| FIDELITY INVESTMENTS EIN 04-2647786 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $109K |
| NISA INVESTMENT ADVISORS LLC EIN 48-1140940 NONE | Investment management; Direct payment from the plan Service code 28 | — | $101K |
| VISION SERVICE PLAN EIN 94-1632821 NONE | Contract Administrator; Direct payment from the plan; Claims processing Service code 12 | — | $66K |
| STATE STREET BANK & TRUST CO. EIN 81-6137331 NONE | Investment management fees paid directly by plan Service code 51 | — | $59K |
| BNY MELLON ASSET MGMT NORTH AMERICA EIN 25-1442864 NONE | Redemption fees; Investment management Service code 28 | — | $43K |
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 | 6,190 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4,130 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 20 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 10,340 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $13.6M |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $14.6M |
| 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.