| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | 75 STATE STREET SUITE 1710 BOSTON, MA 02109 | HARTFORD LIFE AND ACCIDENT | — | $215K | $215K | 2.36% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFIT | 75 STATE STREET SUITE 1710 BOSTON, MA 02109 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $42K | — | $42K | 1.00% |
| BLUE CROSS BLUE SHIELD OF FLORIDA0 Filed as: BLUE CROSS BLUE SHIELD TENNESSEE | 1 CAMERON HILL CHATTANOOGA, TN 37402 | FOUR EVER LIFE INS CO. | — | $5K | $5K | 0.24% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | 1 BEACON STREET SUITE 17100 BOSTON, MA 021091807 | METROPOLITAN LIFE INSURANCE COMPANY | $150K | $26K | $176K | 12.82% |
| ALIGHT SOLUTIONS3 | 4 OVERLOOK PT. LINCOLNSHIRE, IL 600694337 | METROPOLITAN LIFE INSURANCE COMPANY | — | $45K | $45K | 3.27% |
| ALIGHT SOLUTIONS3 Filed as: ALIGHT SOLUTIONS LLC | 901 MAIN STREET SUITE 5800 DALLAS, TN 752023707 | METROPOLITAN LIFE INSURANCE COMPANY | — | $182 | $182 | 0.01% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | 75 STATE STREET SUITE 1710 BOSTON, MA 02109 | HARTFORD LIFE AND ACCIDENT | — | $16K | $16K | 3.22% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | 1 BEACON STREET SUITE 17100 BOSTON, MA 021083107 | METROPOLITAN LIFE INSURANCE COMPANY | $47K | $9K | $56K | 11.56% |
| ALIGHT SOLUTIONS3 | 4 OVERLOOK PT. LINCOLNSHITE, IL 600694337 | METROPOLITAN LIFE INSURANCE COMPANY | — | $14K | $14K | 2.92% |
| ALIGHT SOLUTIONS3 Filed as: ALIGHT SOLUTIONS LLC | 901 MAIN STREET SUITE 5800 DALLAS, TN 752023707 | METROPOLITAN LIFE INSURANCE COMPANY | — | $54 | $54 | 0.01% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | PO BOX 746600 ATLANTA, GA 30374 | METLIFE LEGAL PLANS | $35K | $1K | $37K | 10.21% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | 75 STATE STREET SUITE 1710 BOSTON, MA 02109 | METLIFE LEGAL PLANS | — | $5K | $5K | 1.45% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BCBS OF TENNESSEE EIN 62-0427913 NONE | Contract Administrator Service code 13 | — | $6.6M |
| ALIGHT EIN 36-2235791 NONE | Consulting (general) Service code 16 | 4 OVERLOOK POINT LINCOLNSHIRE, IL 60069 | $3.1M |
| EYEMED (FIDELITY SECURITY INS.) EIN 43-0949844 NONE | Insurance services Service code 23 | — | $2.8M |
| GEOBLUE (WORLDWIDE INS. SERVICES) EIN 23-2903313 NONE | Insurance services Service code 23 | — | $2.2M |
| PLUS ONE HOLDING EIN 13-3613705 NONE | Other services Service code 49 | — | $1.3M |
| BEACON EMPLOYEE ASSISTANCE EIN 54-1414194 NONE | Contract Administrator; Claims processing Service code 12 | 200 STATE STREET BOSTON, MA 02109 | $997K |
| PREMISE HEALTH EMPLOYER SOLUTIONS EIN 23-3057155 NONE | Insurance services; Other services Service code 23 | — | $897K |
| DELOITTE CONSULTING, LLP EIN 06-1454513 NONE | Consulting (general); Accounting (including auditing) Service code 10 | — | $635K |
| DELTA DENTAL OF TENNESSEE EIN 62-0812197 NONE | Contract Administrator; Claims processing Service code 12 | — | $574K |
| THE REED GROUP (GUARDIAN LIFE) EIN 13-5123390 NONE | Contract Administrator; Claims processing Service code 12 | — | $561K |
| OPTUMRX, INC. EIN 33-0441200 NONE | Float revenue; Claims processing; Direct payment from the plan; Other fees Service code 12 | — | $544K |
| TELEDOC HEALTH, INC. EIN 04-3705970 NONE | Direct payment from the plan Service code 50 | — | $350K |
| LBMC EIN 62-1199757 NONE | Accounting (including auditing) Service code 10 | — | $31K |
| HAWAII MEDICAL EIN 99-0040115 NONE | Contract Administrator; Claims processing Service code 12 | — | $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 | 17,072 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5,496 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 241 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 22,809 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | FOUR EVER LIFE INS CO. | 11,769 | $2.6M |
| Dental | FOUR EVER LIFE INS CO. | 558 | $2.1M |
| Vision(6 contracts, 2 carriers) | FOUR EVER LIFE INS CO. | 20,260 | $5.0M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 16,571 | $9.1M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 11,083 | $4.2M |
| Prescription drug | HMSA | 2 | $12K |
| Other(5 contracts, 5 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 19,105 | $2.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 20,260 | — |
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."
No prospect flags tripped on this filing.