| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | 10 STATE HOUSE SQUARE HARTFORD, CT 06103 | CIGNA | $11K | $110K | $121K | 2.18% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | 10 STATE HOUSE SQUARE HARTFORD, CT 06103 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $15K | — | $15K | 4.15% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVS WEST | PO BOX 101162 PASADENA, CA 91189 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 1.53% |
| IMG5 | 2960 NORTH MERIDIAN ST INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $82 | $82 | 0.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | 10 STATE HOUSE SQUARE HARTFORD, CT 06103 | VISION SERVICE PLAN | $2K | — | $2K | 4.40% |
| LINDBERG & RIPPLE INC3 Filed as: LINDBERG & RIPPLE INC. | 29 SOUTH MAIN ST WEST HARTFORD, CT 06107 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 14.08% |
| M FINANCIAL HOLDINGS INC3 Filed as: M FINANCIAL HOLDINGS INC. | 1125 NW COUCH ST PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $122 | $122 | 1.00% |
| LINDBERG & RIPPLE INC3 Filed as: LINDBERG & RIPPLE INC. | 29 SOUTH MAIN ST WEST HARTFORD, CT 06107 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $380 | $19 | $399 | 6.66% |
| M FINANCIAL HOLDINGS INC3 Filed as: M FINANCIAL HOLDINGS INC. | 1125 NW COUCH ST PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $17 | $17 | 0.28% |
| LINDBERG & RIPPLE INC3 Filed as: LINDBERG & RIPPLE INC. | 29 SOUTH MAIN ST WEST HARTFORD, CT 06107 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $754 | — | $754 | 17.06% |
| M FINANCIAL HOLDINGS INC3 Filed as: M FINANCIAL HOLDINGS INC. | 1125 NW COUCH ST PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $92 | $92 | 2.08% |
| LINDBERG & RIPPLE INC3 Filed as: LINDBERG & RIPPLE INC. | 29 SOUTH MAIN ST WEST HARTFORD, CT 06107 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $381 | — | $381 | 17.29% |
| M FINANCIAL HOLDINGS INC3 Filed as: M FINANCIAL HOLDINGS INC. | 1125 NW COUCH ST PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $44 | $44 | 2.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVS INC. | TWO PIERCE PL ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 4.67% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PRUDENTIAL INSURANCE CO OF AMERICA EIN 22-1211670 | Contract Administrator Service code 13 | — | $10K |
| COMPSYCH EIN 35-3739783 | Contract Administrator Service code 13 | — | $2K |
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 | 442 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 442 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA | 334 | $5.6M |
| Dental | CIGNA | 334 | $5.6M |
| Vision(2 contracts, 2 carriers) | CIGNA | 334 | $5.6M |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 442 | $367K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 442 | $367K |
| Long-term disability(6 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 442 | $393K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 442 | — |
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.
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.