| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 250 PARK AVENUE NEW YORK, NY 10177 | AETNA LIFE INSURANCE COMPANY | $26K | $0 | $26K | 1.74% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | PO BOX 414965 BOSTON, MA 02241 | AETNA LIFE INSURANCE COMPANY | $18K | $3K | $22K | 1.48% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | FIRST UNUM LIFE INSURANCE COMPANY | $5K | $0 | $5K | 5.50% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST | 10 STATE HOUSE SQUARE, 1ST FLOOR HARTFORD, CT 06103 | FIRST UNUM LIFE INSURANCE COMPANY | $1K | $345 | $2K | 2.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $691 | $691 | 0.78% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 323 WEST LAKESIDE AVENUE, SUITE 410 CLEVELAND, OH 44113 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $2K | $0 | $2K | 2.89% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | ONE WORLD FINANCIAL CENTER NEW YORK, NY 10281 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $1K | $0 | $1K | 2.10% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS. SVCS. | 300 SOUTH GRAND AVENUE, SUITE 2000 LOS ANGELES, CA 90071 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $0 | $684 | $684 | 1.10% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATON INS. SVCS. | 18101 VON KARMAN AVENUE, SUITE 600 IRVINE, CA 92612 | HEALTH NET | $1K | $0 | $1K | 3.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | VISION SERVICE PLAN | $384 | $0 | $384 | 6.63% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | PO BOX 416672 BOSTON, MA 02241 | VISION SERVICE PLAN | $147 | $0 | $147 | 2.54% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | PO BOX 414965 BOSTON, MA 02241 | VISION SERVICE PLAN | $49 | $0 | $49 | 0.85% |
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 | 132 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 133 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 109 | $1.5M |
| Dental(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 129 | $1.5M |
| Vision | VISION SERVICE PLAN | 43 | $6K |
| Life insurance | FIRST UNUM LIFE INSURANCE COMPANY | 132 | $89K |
| Short-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 132 | $89K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 132 | $89K |
| Prescription drug(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 109 | $1.5M |
| Other | FIRST UNUM LIFE INSURANCE COMPANY | 132 | $89K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 132 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.