| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| 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 | $3K | $24K | $27K | 2.01% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $984 | $8K | $9K | 0.65% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | PO BOX 414965 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 5.98% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICE 785439 | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $532 | — | $532 | 1.24% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | PO BOX 414965 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 10.89% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICE 785439 | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $552 | — | $552 | 2.49% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | PO BOX 414965 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $889 | — | $889 | 9.01% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICE 785439 | 710 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $294 | — | $294 | 2.98% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | — | VISION SERVICE PLAN | $513 | — | $513 | 5.73% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | — | VISION SERVICE PLAN | $206 | — | $206 | 2.30% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | PO BOX 414965 BOSTON, MA 022410001 | VISION SERVICE PLAN | $79 | — | $79 | 0.88% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | PO BOX 414965 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $122 | — | $122 | 8.98% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICE 785439 | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $41 | — | $41 | 3.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIM & CONTRACT ADMIN | Contract Administrator; Direct payment from the plan; Claims processing; Other services; Participant communication; Named fiduciary; Non-monetary compensation; Float revenue Service code 12 | — | $6K |
| CIGNA | Float revenue; Participant communication; Other services; Non-monetary compensation; Direct payment from the plan; Claims processing; Named fiduciary; Contract Administrator Service code 12 | — | $0 |
| CIGNA HEALTHY REWARDS VENDORS | Non-monetary compensation; Claims processing; Contract Administrator; Named fiduciary; Float revenue; Participant communication; Other services; Direct payment from the plan 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 | 116 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 119 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 99 | $1.4M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 99 | $1.4M |
| Vision(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 99 | $1.4M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 120 | $10K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 120 | $43K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 120 | $22K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 120 | $1K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 120 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.