| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 775 YARD STREET SUTIE 200 COLUMBUS, OH 43212 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $29K | — | $29K | 15.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 775 YARD STREET SUITE 200 COLUMBUS, OH 43212 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $8K | — | $8K | 4.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SER WEST | 801 S FIGUEROA STREET SUITE 800 LOS ANGELES, CA 90017 | HARTFORD LIFE AND ACCIDENT | — | $3K | $3K | 3.81% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | WILLIS OF OHIO INC 1001 LAKESIDE AVE CLEVELAND, OH 44114 | HARTFORD LIFE AND ACCIDENT | $2K | — | $2K | 3.04% |
| UTIC INSURANCE COMPANY3 | 450 RIVERCHASE PKWY E BIRMINGHAM, AL 35244 | SUN LIFE ASSURANCE COMPANY OF CANADA | $246 | $4K | $4K | 15.11% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 775 YARD STREET SUITE 200 COLUMBUS, OH 43212 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC. | 775 YARD STREET, SUITE 200 COLUMBUS, OH 43212 | NATIONAL UNION FIRE INS CO OF PITTSBURGH, PA | — | — | $0 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTH CARE INSURANCE CO EIN 36-2738571 CONTRACT ADMINISTRATOR | Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | — | $131K |
| DELTA DENTAL OF OHIO EIN 31-0685339 CONTRACT ADMINISTRATOR | Direct payment from the plan; Contract Administrator; Claims processing Service code 12 | — | $24K |
| MATRIX ABSENCE MANAGEMENT, INC. NONE | Direct payment from the plan; Contract Administrator Service code 13 | 2421 W. PEORIA AVENUE, SUITE 200 PHOENIX, AZ 850294940 | $21K |
| BLUE CROSS & BLUE SHIELD OF ALABAMA EIN 63-0103830 CONTRACT ADMINISTRATOR | Direct payment from the plan; Contract Administrator; Claims processing Service code 12 | — | $17K |
| CONNECTYOURCARE, INC. EIN 46-0891463 NONE | Contract Administrator; Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 13 | — | $8K |
| CANCERBRIDGE EIN 47-1868769 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $6K |
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 | 748 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 752 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 710 | $79K |
| Life insurance(3 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 918 | $397K |
| Long-term disability(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 921 | $267K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 738 | $661K |
| Other(5 contracts, 4 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 936 | $229K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 936 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.