| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE, INC | LOCKBOX 28852 NEW YORK, NY 10087 | HARTFORD LIFE AND ACCIDENT | $38K | — | $38K | 2.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE, INC. | LOCKBOX 28852 NEW YORK, NY 10087 | HARTFORD LIFE AND ACCIDENT | — | $25K | $25K | 1.35% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | LOCKBOX 28852 NEW YORK, NY 10087 | HARTFORD LIFE AND ACCIDENT | $28K | — | $28K | 2.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | LOCKBOX 28852 NEW YORK, NY 10087 | HARTFORD LIFE AND ACCIDENT | — | $16K | $16K | 1.12% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | PO BOX 28852 COMMISSION LOCKBOX #28852 NEW YORK, NY 10087 | KAISER FOUNDATION HEALTH PLAN OF HAWAII, INC. | $12K | — | $12K | 2.00% |
| WILLIS TOWERS WATSON US LLC Filed as: TOWERS WATSON DELAWARE,INC | LOCKBOX 28852 NEW YORK, NY 10087 | HARTFORD LIFE AND ACCIDENT | — | $5K | $5K | 1.27% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | LOCKBOX 28852 NEW YORK, NY 10087 | HARTFORD LIFE AND ACCIDENT | $2K | — | $2K | 1.80% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON PENNSYLVANIA | PO BOX 8500 LOCKBOX #9102 PHILADELPHIA, PA 19178 | HARTFORD LIFE AND ACCIDENT | $235 | — | $235 | 0.20% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DE INC | PO BOX 28852 LOCKBOX 28852 NEW YORK, NY 10087 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 5.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | LOCKBOX 28852 NEW YORK, NY 10087 | HARTFORD LIFE AND ACCIDENT | $376 | — | $376 | 2.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | LOCKBOX 28852 NEW YORK, NY 10087 | HARTFORD LIFE AND ACCIDENT | — | $242 | $242 | 1.29% |
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 | 2,998 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 179 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 107 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,284 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTHPARTNERS, INC. | 71 | $681K |
| Dental(2 contracts, 2 carriers) | HEALTHPARTNERS, INC. | 71 | $681K |
| Vision(4 contracts, 2 carriers) | COMBINED INSURANCE COMPANY OF AMERICA | 7,206 | $294K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 2,997 | $1.9M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 3,021 | $416K |
| Long-term disability(2 contracts) | HARTFORD LIFE AND ACCIDENT | 3,021 | $1.4M |
| Other(3 contracts, 3 carriers) | GUIDEONE SPECIALTY MUTUAL INSURANCE COMPANY | 3,284 | $324K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 7,206 | — |
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.