| 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 | — | $40K | $40K | 1.65% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | BANK OF AMERICA PO BOX 414965 BOSTON, MA 02241 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $28K | $28K | 1.13% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF CONNECTICUT, LLC | PO BOX 414965 BOSTON, MA 02241 | DELTA DENTAL PLAN OF VERMONT, INC. | $4K | — | $4K | 1.90% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | 800 BOYLSTON STREET, STE 600 BOSTON, MA 02199 | DELTA DENTAL PLAN OF VERMONT, INC. | $4K | — | $4K | 1.83% |
| COMBINED SERVICES LLC3 | DBA CSONE BENEFIT SOLUTIONS PO BOX 1320 CONCORD, NH 03302 | DELTA DENTAL PLAN OF VERMONT, INC. | $2K | — | $2K | 0.90% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | PO BOX 414965 BOSTON, MA 02241 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $11K | $322 | $12K | 6.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF CONNECTICUT, LLC | PO BOX 414965 BOSTON, MA 02241 | VISION SERVICE PLAN | $926 | — | $926 | 3.19% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | PO BOX 414965 BOSTON, MA 02241 | VISION SERVICE PLAN | $450 | — | $450 | 1.55% |
No Schedule C service providers reported on this filing.
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 | 278 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 286 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 200 | $2.5M |
| Dental | DELTA DENTAL PLAN OF VERMONT, INC. | 459 | $233K |
| Vision | VISION SERVICE PLAN | 173 | $29K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 278 | $194K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 278 | $194K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 278 | $194K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 200 | $2.5M |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 278 | $194K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 459 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.