| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | PO BOX 13784 NEWARK, NJ 07188 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $90K | $90K | 1.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 12505 PARK POTOMAC AVE STE 300 POTOMAC, MD 20854 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $20K | — | $20K | 5.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 7733 FORSYTH BLVD STE 1350 SAINT LOUIS, MO 63105 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $4K | $4K | 1.14% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 29727 NETWORK PLACE CHICAGO, IL 60673 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $3K | — | $3K | 7.87% |
| RIGGS COUNSELMAN MICHAELS & DOWNES3 Filed as: RIGGS COUNSELMAN MICHAELS | ATTN ACCOUNTING DEPT 555 FAIRMONT AVE BALTIMORE, MD 21286 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $135 | — | $135 | 16.63% |
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 | 788 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 40 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 831 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 696 | $10.1M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 696 | $9.0M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 1,376 | $39K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 1,394 | $394K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 1,394 | $394K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 696 | $10.1M |
| Other(3 contracts, 3 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 1,394 | $395K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,394 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.