| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $85K | $4K | $89K | 14.35% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA INC | 16220 N SCOTTSDALE RD STE 600 SCOTTSDALE, AZ 85254 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | — | $5K | $5K | 0.83% |
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 P.O. BOX 28852 NEW YORK, NY 100878852 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $66K | $3K | $69K | 14.43% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA INC | 16220 N SCOTTSDALE RD STE 600 SCOTTSDALE, AZ 85254 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | — | $4K | $4K | 0.85% |
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | SUN LIFE ASSURANCE COMPANY OF CANADA | $20K | $12K | $33K | 14.76% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 100878852 | RELIASTAR LIFE INSURANCE COMPANY | $41K | — | $41K | 22.05% |
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | FIDELITY SECURITY LIFE INSURANCE COMPANY (EYEMED VISION CARE) | $15K | — | $15K | 9.34% |
| WILLIS TOWERS WATSON US LLC3 | CENTRE SQUARE EAST 1500 MARKET STREET PHILADELPHIA, PA 19102 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $11K | — | $11K | 7.00% |
| IVAN RODRIGUEZ ARCE3 | URB ENCANTADA SECC ANTILLANA AN 31 CALLE SAN VINCENTE TRUJILLO ALTO, PR 00976 | TRIPLE S SALUD, INC. | $5K | — | $5K | 5.00% |
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $91 | $2K | 15.73% |
| IVAN RODRIGUEZ ARCE3 Filed as: IVAN R RODRIGUEZ | URB ENCANTADA SECC ANTILLANA AN 31 CALLE SAN VICENTE TRUJILO ALTO, PR 00976 | DELTA DENTAL OF PUERTO RICO, INC. | $456 | — | $456 | 10.00% |
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 | 1,593 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 28 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,621 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 102 | $397K |
| Dental(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 195 | $161K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY (EYEMED VISION CARE) | 2,544 | $163K |
| Life insurance(2 contracts, 2 carriers) | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 1,588 | $729K |
| Short-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 73 | $22K |
| Long-term disability | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 1,334 | $480K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 102 | $397K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 840 | $221K |
| Other(5 contracts, 5 carriers) | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 1,925 | $965K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,544 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.