| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF CONNECTICUT LLC | 10 STATE HOUSE SQUARE , 11TH FLOOR HARTFORD, CT 06103 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $2K | $22K | $24K | 1.84% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WASTON NORTHEAST INC | BANK OF AMERICA PO BOX 414965 BOSTON, MA 022414965 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $2K | $16K | $18K | 1.34% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | PO BOX 414965 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $359 | $2K | 5.30% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | 10 STATE HOUSE SQUARE FLOOR 11 HARTFORD, CT 06103 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 3.75% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | 10 STATE HOUSE SQUARE FLOOR 11 HARTFORD, CT 06103 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 10.04% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | PO BOX 414965 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $764 | $186 | $950 | 6.17% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF CONNECTICUT, LLC | PO BOX 414965 BOSTON, MA 022410001 | VISION SERVICE PLAN | $517 | — | $517 | 4.90% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | PO BOX 414965 BOSTON, MA 022414965 | VISION SERVICE PLAN | $217 | — | $217 | 2.06% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | PO BOX 414965 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $446 | $82 | $528 | 6.57% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | 10 STATE HOUSE SQUARE FLOOR 11 HARTFORD, CT 06103 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $518 | — | $518 | 6.45% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | PO BOX 414965 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $61 | $11 | $72 | 6.51% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | 10 STATE HOUSE SQUARE FLOOR 11 HARTFORD, CT 06103 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $71 | — | $71 | 6.42% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIM & CONTRACT ADMIN | Contract Administrator; Claims processing Service code 12 | — | $4K |
| CIGNA | Participant communication; Direct payment from the plan; Non-monetary compensation; Claims processing; Contract Administrator; Other services; Float revenue; Named fiduciary Service code 12 | — | $0 |
| CIGNA HEALTHY REWARDS VENDORS | Non-monetary compensation; Direct payment from the plan; Contract Administrator; Other services; Participant communication; Named fiduciary; Claims processing; Float revenue Service code 12 | — | $0 |
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 | 127 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 129 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 115 | $1.3M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 115 | $1.3M |
| Vision(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 115 | $1.3M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 129 | $8K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 129 | $35K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 129 | $15K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 129 | $1K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 129 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.