| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | 200 LIBERTY STREET NEW YORK, NY 10281 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $11K | — | $11K | 6.53% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS W INC | P.O. BOX 101162 PASADENA, CA 91189 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $4K | $4K | 2.61% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $32 | $32 | 0.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | 200 LIBERTY ST, 6TH FL. NEW YORK, NY 10281 | LINCOLN LIFE AND ANNUITY COMPANY OF NEW YORK | $6K | — | $6K | 4.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | 1 WORLD FINANCIAL CENTER 200 LIBERTY ST NEW YORK, NY 10281 | EYEMED VIS. CARE ON BEHALF OF FIDELITY SEC. LIFE INS. CO. OF NEW YORK | $6K | — | $6K | 13.74% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | 800 BOYLSTON STREET BOSTON, MA 02199 | EYEMED VIS. CARE ON BEHALF OF FIDELITY SEC. LIFE INS. CO. OF NEW YORK | $650 | — | $650 | 1.45% |
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 | 123 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 126 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | LINCOLN LIFE AND ANNUITY COMPANY OF NEW YORK | 118 | $160K |
| Vision | EYEMED VIS. CARE ON BEHALF OF FIDELITY SEC. LIFE INS. CO. OF NEW YORK | 305 | $45K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 124 | $164K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 124 | $164K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 124 | $164K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 124 | $164K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 305 | — |
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.