| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | ONE WORLD FINANCIAL CENTER 200 LIBERTY ST, 6TH FL. NEW YORK, NY 10281 | THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK | $17K | — | $17K | 2.48% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | ONE WORLD FINANCIAL CENTER 200 LIBERTY ST, 6TH FL. NEW YORK, NY 10281 | THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK | $8K | — | $8K | 2.08% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC | ONE WORLD FINANCIAL CTR 200 LIBERTY STREET, FL. 6 NEW YORK, NY 10281 | AETNA LIFE INSURANCE CO. | $8K | $4K | $12K | 7.69% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | 200 LIBERTY STREET NEW YORK, NY 10281 | JOHN HANCOCK | $13K | — | $13K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | 200 LIBERTY STREET, 6TH FLOOR NEW YORK, NY 10281 | EMPIRE HEALTHCHOICE HMO, INC. | $312 | — | $312 | 1.04% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | PO BOX 1969 MORRISTOWN, NJ 07962 | EMPIRE HEALTHCHOICE HMO, INC. | $5 | — | $5 | 0.02% |
| MMG AGENCY INC.3 | 32 BROADWAY STE 1818 NEW YORK, NY 10004 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $4K | — | $4K | 15.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | ONE WORLD FINANCIAL CENTER 200 LIBERTY STREET NEW YORK, NY 10281 | GUIDEONE SPECIALTY MUTUAL INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK | ONE WORLD FINANCIAL CTR 200 LIBERTY STREET, FL. 6 NEW YORK, NY 10281 | AETNA LIFE INSURANCE CO. | $532 | — | $532 | 4.95% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK | ONE WORLD FINANCIAL CTR 200 LIBERTY STREET, FL. 6 NEW YORK, NY 10281 | AETNA LIFE INSURANCE CO. | $264 | — | $264 | 4.88% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | ONE WORLD FINANCIAL CTR 200 LIBERTY STREET, FL. 6 NEW YORK, NY 10281 | AETNA LIFE INSURANCE CO. | $27 | — | $27 | 4.49% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC | ONE WORLD FINANCIAL CTR 200 LIBERTY STREET, FL. 6 NEW YORK, NY 10281 | AETNA LIFE INSURANCE CO. | $28 | — | $28 | 4.85% |
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 | 1,717 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 324 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,041 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE HMO, INC. | 0 | $30K |
| Dental(5 contracts) | AETNA LIFE INSURANCE CO. | 918 | $173K |
| Vision | EMPIRE HEALTHCHOICE HMO, INC. | 0 | $30K |
| Life insurance | THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK | 2,291 | $682K |
| Long-term disability | THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK | 1,803 | $378K |
| Other(5 contracts, 5 carriers) | THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK | 2,291 | $948K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,291 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.