| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 | COM LOCKBOX 28852 P.O. LOCKBOX 28852 NEW YORK, NY 10087 | MINNESOTA LIFE INSURANCE COMPANY | $176K | $137K | $314K | 5.29% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | COMMISSION LOCKBOX 28852 P.O. BOX 28852 NEW YORK, NY 10087 | LIBERTY LIE ASSURANCE COMPANY OF BOSTON | $15K | $57K | $72K | 2.08% |
| WILLIS TOWERS WATSON US LLC3 | COM LOCKBOX 28852 P.O. LOCKBOX 28852 NEW YORK, NY 10087 | MINNESOTA LIFE INSURANCE COMPANY | $0 | $42K | $42K | 2.31% |
| MERCER HEALTH AND BENEFITS, LLC Filed as: MERCER HEALYH & BENEFITS LLC | — | CIGNA HEALTH & LIFE INSURANCE COMPANY | $98K | $0 | $98K | 6.04% |
| WILLIS TOWERS WATSON US LLC Filed as: TOWERS WATSON DELAWARE INC. | — | CIGNA HEALTH & LIFE INSURANCE COMPANY | $18K | $0 | $18K | 1.13% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CVS EIN 05-0340626 CLAIMS PROCESSOR - RX | Claims processing Service code 12 | — | $19.3M |
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR - MEDICL | Other services; Claims processing Service code 12 | — | $7.4M |
| KAISER FOUNDATION HEALTH PLAN INC. EIN 94-1340523 CLAIMS PROCESSOR - MEDICL | Claims processing; Other services Service code 12 | — | $1.4M |
| ANTHEM EIN 95-3760980 CLAIMS PROCESSOR - EAP | Claims processing Service code 12 | — | $517K |
| DELTA DENTAL EIN 94-1461312 CLAIMS PROCESSOR -DENTAL | Claims processing Service code 12 | — | $445K |
| LIBERTY LIFE ASSURANCE CO OF BOSTON EIN 04-6076039 CLAIMS PROCESSOR - LOA | Claims processing Service code 12 | — | $248K |
| LIBERTY LIFE ASSURANCE CO. OF BOSTO EIN 04-6076039 CLAIMS PROCESSOR - STD | Claims processing Service code 12 | — | $187K |
| VISION SERVICE PLAN EIN 94-1632821 CLAIMS PROCESOR - VISION | Claims processing Service code 12 | — | $180K |
| WAGEWORKS, INC. EIN 94-3351864 COBRA CLAIMS ADMIN | Contract Administrator Service code 13 | — | $46K |
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 | 14,055 | 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. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 14,055 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF CALIFORNIA | 18,985 | $16.4M |
| Vision | VISION SERVICE PLAN | 5,500 | $5.5M |
| Life insurance(2 contracts) | MINNESOTA LIFE INSURANCE COMPANY | 22,862 | $7.7M |
| Long-term disability | LIBERTY LIE ASSURANCE COMPANY OF BOSTON | 13,473 | $3.4M |
| Other(4 contracts, 3 carriers) | DELTA DENTAL OF CALIFORNIA | 18,985 | $23.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 22,862 | — |
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.