| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | ONE WORLD FINANCIAL CTR 6TH FL, 200 LIBERTY ST NEW YORK, NY 10281 | FIRST UNUM LIFE INSURANCE COMPANY | — | $12K | $12K | 2.50% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | CHURCH STREET P O BOX 4557 NEW YORK, NY 10249 | DELAWARE AMERICAN LIFE INSURANCE COMPANY | $708 | — | $708 | 1.16% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | 1 WORLD FINANCIAL CENTER 200 LIBERTY ST., 6TH FL NEW YORK, NY 10281 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | — | $5K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST | 233 S WACKER DR STE 1800 CHICAGO, IL 60606 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $3K | $3K | 5.95% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | ONE WORLD FINANCIAL CTR 6TH FL, 200 LIBERTY ST NEW YORK, NY 10281 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | — | $620 | $620 | 2.48% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | ONE WORLD FINANCIAL CTR 6TH FL, 200 LIBERTY ST NEW YORK, NY 10281 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | — | $444 | $444 | 2.51% |
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 | 629 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 61 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 694 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 3 | $61K |
| Dental | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 3 | $61K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INS CO OF NY | 1,057 | $46K |
| Life insurance(2 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 822 | $531K |
| Long-term disability(2 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 822 | $531K |
| Other(5 contracts, 3 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 822 | $588K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,057 | — |
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.