| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | COM LOCKBOX 28852 P.O. BOX 28852 NEW YORK, NY 10087 | MINNESOTA LIFE INSURANCE COMPANY | $311K | $141K | $452K | 7.21% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | COMMISSION LOCKBOX 28852 P.O. BOX 28852 NEW YORK, NY 10087 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $197K | $67K | $264K | 7.74% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | COM LOCKBOX 28852 P.O. BOX 28852 NEW YORK, NY 10087 | MINNESOTA LIFE INSURANCE COMPANY | $0 | $42K | $42K | 2.25% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $124K | — | $124K | 7.78% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | LOCKBOX #28852 P.O. BOX 28852 NEW YORK, NY 10087 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $3K | $8K | 3.74% |
| ALLIANT INSURANCE SERVICES, INC. Filed as: ALLIANT INSURANCE SERVICE | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $14K | $1K | $15K | 22.87% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES INC. EIN 41-1289245 CLAIMS PROCESSOR/MEDICAL | Claims processing; Other services Service code 12 | — | $8.4M |
| KAISER FOUNDATION HEALTH PLAN INC. EIN 94-1340523 CLAIMS PROCESSOR/MEDICAL | Other services; Claims processing Service code 12 | — | $1.9M |
| LIBERTY LIFE ASSURANCE CO OF BOSTON EIN 04-6076039 CLAIMS PROCESSOR-CA VDI | Claims processing Service code 12 | — | $754K |
| ANTHEM BLUE CROSS EIN 95-3760980 EAP CONTRACT ADMINISTRATO | Claims processing Service code 12 | — | $540K |
| DELTA DENTAL OF CALIFORNIA EIN 94-1461312 CLAIMS PROCESSOR / DENTAL | Claims processing; Other services Service code 12 | — | $500K |
| CONNECTYOURCARE HSA/FSA/DCRA ADMINISTRATO | Claims processing Service code 12 | 307 INTERNATIONAL CIRCLE SUITE 200 HUNT VALLEY, MD 21030 | $405K |
| WAGEWORKS , INC. EIN 94-3351864 COBRA CONTRACT ADMINISTRA | Contract Administrator Service code 13 | — | $202K |
| VISION SERVICE PLAN EIN 94-1632821 CLAIMS PROCESSOR - VISION | Claims processing Service code 12 | — | $172K |
| CVS PHARMACY INC. EIN 05-0340626 CLAIMS PROCESSOR - RX | Other services; Claims processing Service code 12 | — | $63K |
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 | 13,570 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 13,570 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL | 20,923 | $19.6M |
| Vision | VISION SERVICE PLAN | 6,167 | $5.1M |
| Life insurance(3 contracts, 2 carriers) | MINNESOTA LIFE INSURANCE COMPANY | 27,546 | $8.3M |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 16,246 | $3.4M |
| Other(8 contracts, 6 carriers) | DELTA DENTAL | 27,546 | $34.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 27,546 | — |
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.