| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MASSACHUSETTS INC. | PO BOX 416672 BOSTON, MA 02241 | THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK | $11K | — | $11K | 7.82% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC EIN 23-7391136 NONE | Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Contract Administrator; Claims processing Service code 12 | — | $483K |
| STATE STREET GLOBAL ADVISORS EIN 04-1867445 TRUSTEE | Investment management fees paid directly by plan; Soft dollars commissions; Custodial (securities); Custodial (other than securities) Service code 18 | — | $419K |
| UNITEDHEALTHCARE SERVICES, LLC EIN 47-0854646 NONE | Other services; Claims processing Service code 12 | — | $328K |
| EXPRESS SCRIPTS, INC. EIN 22-3461740 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $19K |
| TOWERS WATSON DELAWARE INC EIN 53-0181291 NONE | Insurance agents and brokers; Insurance brokerage commissions and fees; Other commissions Service code 22 | — | $13K |
| TOWERS WATSON PENNSYLVANIA INC EIN 23-1159360 NONE | Insurance brokerage commissions and fees; Insurance agents and brokers; Other commissions Service code 22 | — | $11K |
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 NONE | Non-monetary compensation; Float revenue; Claims processing; Other services; Contract Administrator; Direct payment from the plan; Participant communication; Named fiduciary Service code 12 | — | $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 | 15,708 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,803 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 17,511 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | UNITED HEALTHCARE INSURANCE COMPANY | 54 | $253K |
| Life insurance | THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK | 1,115 | $147K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,115 | — |
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.