| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 801 S FIGUEROA STREET SUITE 800 LOS ANGELES, CA 90017 | HARTFORD LIFE AND ACCIDENT | — | $10K | $10K | 1.36% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | 800 BOYLSTON STREET SUITE 600 BOSTON, MA 02199 | HARTFORD LIFE AND ACCIDENT | $7K | — | $7K | 0.92% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS, LLC | 501 OFFICE CENTER DRIVE FORT WASHINGTON, PA 19034 | HARTFORD LIFE AND ACCIDENT | — | $1K | $1K | 0.15% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | PO BOX 416672 BOSTON, MA 02241 | METROPOLITAN LIFE INSURANCE COMPANY | $18K | $64 | $18K | 2.70% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | 200 LIBERTY ST FL 6 1 WORLD FINANCIAL CENTER NEW YORK, NY 10281 | METROPOLITAN LIFE INSURANCE COMPANY | — | $12K | $12K | 1.80% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS, LLC | 1800 WEST LOOP S STE 2115 HOUSTON, TN 77027 | METROPOLITAN LIFE INSURANCE COMPANY | — | $631 | $631 | 0.09% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | 100 BANK ST STE 500 BURLINGTON, VT 05401 | KAISER FOUNDATION HEALTH PLAN, INC. | $6K | — | $6K | 4.15% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | PO BOX 416672 BOSTON, MA 02241 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | $192 | $10K | 11.77% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | 200 LIBERTY ST FL 6 1 WORLD FINANCIAL CENTER NEW YORK, NY 10281 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 1.90% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS, LLC | 1800 WEST LOOP S STE 2115 HOUSTON, TX 77027 | METROPOLITAN LIFE INSURANCE COMPANY | — | $111 | $111 | 0.13% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | 800 BOYLSTON ST STE 600 BOSTON, MA 02199 | HARTFORD LIFE AND ACCIDENT | $3K | $462 | $4K | 7.32% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS, LLC | PO BOX 107 SAN JOSE, CA 95103 | HARTFORD LIFE AND ACCIDENT | -$2K | $412 | -$1K | -2.84% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | PO BOX 416672 BOSTON, MA 02241 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $191 | $5K | 11.48% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | 200 LIBERTY ST FL 6 1 WORLD FINANCIAL CENTER NEW YORK, NY 10281 | METROPOLITAN LIFE INSURANCE COMPANY | — | $855 | $855 | 1.81% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS, LLC | 1800 WEST LOOP S STE 2115 HOUSTON, TX 77027 | METROPOLITAN LIFE INSURANCE COMPANY | $12 | $61 | $73 | 0.15% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | PO BOX 416672 BOSTON, MA 02241 | METROPOLITAN GENERAL INSURANCE COMPANY | $5K | — | $5K | 10.47% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK, INC. | P.O. BOX 416672 BOSTON, MA 02241 | METROPOLITAN GENERAL INSURANCE COMPANY | — | $663 | $663 | 1.54% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB, ROGAL, & HOBBS, LLC | 100 PARK AVENUE 14TH FLOOR NEW YORK, NY 10017 | METROPOLITAN GENERAL INSURANCE COMPANY | — | $266 | $266 | 0.62% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS, LLC | 501 OFFICE CENTER DRIVE, STE 215 FORT WASHINGTON, PA 19034 | METROPOLITAN GENERAL INSURANCE COMPANY | -$1K | — | -$1K | -2.87% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | PO BOX 416672 BOSTON, MA 02241 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $191 | $5K | 11.82% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | 200 LIBERTY ST FL 6 ONE WORLD FINANCIAL CENTER NEW YORK, NY 10281 | METROPOLITAN LIFE INSURANCE COMPANY | — | $756 | $756 | 1.94% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS, LLC | 1800 WEST LOOP S STE 2115 HOUSTON, TX 77027 | METROPOLITAN LIFE INSURANCE COMPANY | — | $59 | $59 | 0.15% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS, LLC | PO BOX 107 SAN JOSE, CA 95103 | METROPOLITAN LIFE INSURANCE COMPANY | $16 | — | $16 | 0.04% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | 800 BOYLSTON STREET SUITE 600 BOSTON, MA 52199 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $2K | — | $2K | 4.70% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | 200 LIBERTY ST FL 6 1 WORLD FINANCIAL CENTER NEW YORK, NY 10281 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | — |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | 75 ARLINGTON STREET FL 10 BOSTON, MA 02116 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | — |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SVCS, LLC | 1800 WEST LOOP S STE 2115 HOUSTON, TX 77027 | METROPOLITAN LIFE INSURANCE COMPANY | — | $258 | $258 | — |
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 | 918 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 931 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN, INC. | 11 | $134K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 832 | $38K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 2,833 | $730K |
| Short-term disability(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 943 | $666K |
| Long-term disability(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 943 | $666K |
| Other(7 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 918 | $399K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,833 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.