| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | PO BOX 288852 COMMISSION LOCKBOX 28852 NEW YORK, NY 10087 | SUN LIFE ASSURANCE COMPANY OF CANADA | $96K | — | $96K | 8.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | 201 EAST 5TH STREET, STE 1250 CINCINNATI, OH 45202 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $6K | $6K | 0.52% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE IN | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $12K | — | $12K | 3.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE IN | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $2K | $5K | 2.47% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE IN | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $577 | $2K | 2.29% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE IN | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $695 | $360 | $1K | 2.28% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MASS. EIN 04-1045815 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $994K |
| CVS PHARMACY, INC. EIN 05-0340626 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $436K |
| ACCLAIM, INC. EIN 72-1356116 CONTRACT ADMINISTRATOR | Contract Administrator; Direct payment from the plan Service code 13 | — | $72K |
| DELTA DENTAL EIN 11-1980218 NONE | Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | — | $67K |
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 NONE | Contract Administrator; Direct payment from the plan; Claims processing Service code 12 | — | $56K |
| CIGNA BEHAVIORAL HEALTH, INC. EIN 41-1648670 NONE | Contract Administrator; Claims processing; Participant communication; Direct payment from the plan Service code 12 | — | $34K |
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 | 2,876 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 107 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,983 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | GEISINGER QUALITY OPTIONS, INC. | 93 | $856K |
| Vision | VISION SERVICE PLAN | 2,140 | $324K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 5,371 | $1.2M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 686 | $217K |
| Long-term disability(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,737 | $445K |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 5,371 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,371 | — |
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.