| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | 300 AIRBORNE PKWY, STE 208 BUFFALO, NY 14225 | UNITEDHEALTHCARE INSURANCE COMPANY | $79K | — | $79K | 3.29% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | ONE WORLD FINANCIAL CENTER 200 LIBERTY ST NEW YORK, NY 10281 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $6K | $6K | 0.25% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | ONE WORLD FINANCIAL CTR 6TH FL., 200 LIBERTY ST NEW YORK, NY 10281 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $4K | $14K | 7.74% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK | 1 WORLD FINANCIAL CTR 200 LIBERTY ST, 6TH FL. NEW YORK, NY 10281 | AETNA LIFE INSURANCE CO. | $7K | — | $7K | 3.72% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | ONE WORLD FINANCIAL CTR 6TH FL., 200 LIBERTY ST NEW YORK, NY 10281 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 5.58% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | ONE WORLD FINANCIAL CTR 6TH FL., 200 LIBERTY ST NEW YORK, NY 10281 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $1K | $10K | 16.17% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | ONE WORLD FINANCIAL CTR 6TH FL., 200 LIBERTY ST NEW YORK, NY 10281 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 20.07% |
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 | 270 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 281 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 442 | $2.4M |
| Dental | AETNA LIFE INSURANCE CO. | 419 | $180K |
| Vision | AETNA LIFE INSURANCE CO. | 419 | $180K |
| Life insurance(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 274 | $414K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 274 | $169K |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 274 | $349K |
| Other(4 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 274 | $440K |
| 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."
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.