| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITSTORE INC3 Filed as: BENEFITSTORE, INC. | 100 BENEFITFOCUS WAY CHARLESTON, SC 29492 | CONTINENTAL AMERICAN INSURANCE COMPANY | $223K | $0 | $223K | 25.55% |
| LOCKTON COMPANIES, LLC3 | 777 SOUTH FIGUEROA STREET SUITE 5200 LOS ANGELES, CA 90017 | KAISER FOUNDATION HEALTH PLAN INC | $3K | $0 | $3K | 0.42% |
| LOCKTON COMPANIES, LLC3 | 777 SOUTH FIGUEROA STREET SUITE 5200 LOS ANGELES, CA 90017 | KAISER FOUNDATION HEALTH PLAN INC | $1K | $0 | $1K | 0.21% |
| LOCKTON COMPANIES, LLC3 | 725 SOUTH FIGUEROA STREET 35TH FLOOR LOS ANGELES, CA 90017 | SYMETRA LIFE INSURANCE COMPANY | $22K | $0 | $22K | 5.00% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | SYMETRA LIFE INSURANCE COMPANY | $0 | $14K | $14K | 3.10% |
| CFA LLC3 | 1501 SOUTH CLINTON STREET BALTIMORE, MD 21224 | SYMETRA LIFE INSURANCE COMPANY | $0 | $13K | $13K | 2.85% |
| LOCKTON COMPANIES, LLC3 | 777 SOUTH FIGUEROA STREET SUITE 5200 LOS ANGELES, CA 90017 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $31K | $0 | $31K | 10.00% |
| BENEFITSTORE INC3 Filed as: BENEFITSTORE, INC. | 100 BENEFITFOCUS WAY CHARLESTON, SC 29492 | TRANSAMERICA LIFE INSURANCE COMPANY | $131K | $0 | $131K | 47.76% |
| BENEFITSTORE INC3 Filed as: BENEFITSTORE, INC. | 100 BENEFITFOCUS WAY CHARLESTON, SC 29492 | ARAG INSURANCE COMPANY | $18K | — | $18K | 10.00% |
| BENEFITSTORE INC5 Filed as: BENEFITSTORE, INC. | 100 BENEFITFOCUS WAY CHARLESTON, SC 29492 | ARAG INSURANCE COMPANY | $0 | $9K | $9K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAREFIRST EIN 53-0078070 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $209K |
| GOVERNMENT SERVICE ADMINISTRATORS EIN 36-4829385 TPA ADMIN FEES | Recordkeeping fees Service code 64 | — | $174K |
| UNITED CONCORDIA COMPANIES, INC. EIN 25-1687586 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $25K |
| VISION SERVICE PLAN EIN 23-7089668 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $10K |
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 | 9,211 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 116 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 9,327 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 115 | $1.6M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 18 | $403K |
| Vision | HAWAII MEDICAL SERVICE ASSOCIATION | 18 | $97K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 9,131 | $9.6M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 9,131 | $9.3M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 9,131 | $9.3M |
| Prescription drug(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 115 | $1.3M |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 4,552 | $446K |
| Other(7 contracts, 7 carriers) | HARTFORD LIFE AND ACCIDENT | 9,211 | $10.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 9,211 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.