| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF CONNECTICUT, INC. | PO BOX 414965 BOSTON, MA 02241 | MVP HEALTHCARE | $20K | $0 | $20K | 4.38% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF CONNECTICUT, INC. | PO BOX 414965 BOSTON, MA 02241 | DELTA DENTAL PLAN OF VERMONT, INC. | $2K | $0 | $2K | 4.87% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES, LLC | PO BOX 1320 CONCORD, NH 03302 | DELTA DENTAL PLAN OF VERMONT, INC. | $300 | $0 | $300 | 0.82% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF CONNECTICUT, INC. | PO BOX 414965 BOSTON, MA 02241 | VISION SERVICE PLAN | $588 | $0 | $588 | 8.70% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF CONNECTICUT, INC. | PO BOX 414965 BOSTON, MA 02241 | SUN LIFE ASSURANCE COMPANY OF CANADA | $418 | $0 | $418 | 12.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF CALIFORNIA, INC. | PO BOX 101162 PASADENA, CA 91189 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $46 | $46 | 1.32% |
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 | 131 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 46 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 177 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MVP HEALTHCARE | 115 | $458K |
| Dental | DELTA DENTAL PLAN OF VERMONT, INC. | 85 | $37K |
| Vision | VISION SERVICE PLAN | 68 | $7K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 131 | $3K |
| Prescription drug | MVP HEALTHCARE | 115 | $458K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 131 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 131 | — |
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.
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.