| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $150K | $17K | $168K | 14.79% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX 28852 P.O. BOX 28852 NEW YORK, NY 10087 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $107K | $11K | $118K | 16.52% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | SUN LIFE ASSURANCE COMPANY OF CANADA | $53K | $32K | $86K | 16.00% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 100878852 | RELIASTAR LIFE INSURANCE COMPANY | $105K | — | $105K | 21.64% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | FIDELITY SECURITY LIFE INSURANCE COMPANY (EYEMED VISION CARE) | $27K | — | $27K | 9.79% |
| 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 | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | ZURICH AMERICAN INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | ZURICH AMERICAN INSURANCE COMPANY | — | $1K | $1K | 15.00% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | ZURICH AMERICAN INSURANCE COMPANY | — | $427 | $427 | 5.00% |
| 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. | $611 | — | $611 | 10.00% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | FIDELITY SECURITY LIFE INSURANCE COMPANY (EYEMED VISION CARE) | $241 | — | $241 | 9.74% |
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 | 2,733 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 19 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 106 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,858 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 104 | $756K |
| Dental | DELTA DENTAL OF PUERTO RICO, INC. | 18 | $6K |
| Vision(2 contracts) | FIDELITY SECURITY LIFE INSURANCE COMPANY (EYEMED VISION CARE) | 4,436 | $277K |
| Life insurance(2 contracts, 2 carriers) | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 2,733 | $1.2M |
| Short-term disability | AMERICAN UNITED LIFE INSURANCE COMPANY | 82 | $42K |
| Long-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 2,331 | $715K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 104 | $756K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 994 | $535K |
| Other(5 contracts, 5 carriers) | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 3,029 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,436 | — |
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.