| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON | P.O. BOX 28852 NEW YORK, NY 10087 | METLIFE | $719K | $397K | $1.1M | 2.02% |
| AGSIEBEN AND ASSOCIATES, INC.3 | 800 AIRPORT BLVD., 318 BURLINGAME, CA 94010 | METLIFE | $96K | $0 | $96K | 0.17% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON | P.O. BOX 28852 NEW YORK, NY 10087 | HARTFORD LIFE & ACCIDENT | $0 | $289K | $289K | 1.06% |
| AGSIEBEN AND ASSOCIATES, INC.3 | 800 AIRPORT BLVD., 318 BURLINGAME, CA 94010 | HARTFORD LIFE & ACCIDENT | $230K | $0 | $230K | 0.85% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON | P.O. BOX 28852 NEW YORK, NY 10087 | VOYA | $228K | $685K | $913K | 8.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON | P.O. BOX 28852 NEW YORK, NY 10087 | CIGNA | $0 | $0 | $0 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE EIN 36-2739571 CONTRACT ADMINISTRATION | Contract Administrator Service code 13 | 425 MARKET STREET SAN FRANCISCO, CA 94105 | $22.2M |
| METLIFE EIN 13-5581829 CONTRACT ADMINISTRATION | Contract Administrator Service code 13 | 501 U.S. HIGHWAY 22 BRIDGEWATER, NJ 08807 | $2.6M |
| VISION SERVICE PLAN EIN 94-1632821 CONTRACT ADMINISTRATION | Contract Administrator Service code 13 | P.O. BOX 495918 CINCINNATI, OH 45249 | $658K |
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 | 63,298 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,000 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 64,302 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | METLIFE | 63,298 | $55.2M |
| Short-term disability(2 contracts) | HARTFORD LIFE & ACCIDENT | 63,298 | $27.2M |
| Long-term disability | HARTFORD LIFE & ACCIDENT | 63,298 | $27.2M |
| Prescription drug(6 contracts, 6 carriers) | KAISER CALIFORNIA | 2,990 | $44.9M |
| Stop-loss / reinsurancereinsurance | VOYA | 64,302 | $11.4M |
| Other(3 contracts, 3 carriers) | METLIFE | 63,298 | $55.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 64,302 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.