| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC | 122 EAST COLLEGE AVENUE SUITE 201 APPLETON, WI 54911 | GUARDIAN | $11K | $2K | $13K | 3.18% |
| PLANNED ADMINISTRATORS, INC.5 | 17 TECHNOLOGY CIRCLE SUITE E2AG COLUMBIA, SC 29203 | BCS INSURANCE COMPANY | — | $30K | $30K | 14.50% |
| INSURANCE APPLICATIONS GROUP3 | 220 N MAIN STREET GREENVILLE, SC 29601 | BCS INSURANCE COMPANY | $28K | — | $28K | 13.44% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC | 400 N EXECUTIVE DR STE 300 BROOKFIELD, WI 53005 | BCS INSURANCE COMPANY | $10K | — | $10K | 5.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC | 400 N EXECUTIVE DR SUITE 300 BROOKFIELD, WI 53005 | HARTFORD LIFE AND ACCIDENT | $15K | — | $15K | 11.03% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA | PO BOX 101162 PASADENA, CA 91189 | HARTFORD LIFE AND ACCIDENT | — | $2K | $2K | 1.19% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN | 2323 NORTH MAYFAIR ROAD SUITE 600 MILWAUKEE, WI 56226 | HARTFORD LIFE AND ACCIDENT | $647 | — | $647 | 0.46% |
| BENEFITSTORE INC3 | ATTN JENNIFER KEATING 100 BENEFITFOCUS WAY CHARLESTON, SC 29492 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $13K | — | $13K | 14.03% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN | 93033 NETWORK PLACE CHICAGO, IL 60673 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $6K | — | $6K | 6.59% |
| JT-MARIKOS INS AGENCY INC3 | 200 WINTON RD NORTH ROCHESTER, NY 14610 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4K | — | $4K | 3.91% |
| JOHNATHAN GUAY3 | 1100 LONG POND RD SUITE 119 ROCHESTER, NY 14626 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $607 | — | $607 | 0.66% |
| WAYNE A LEVAN3 | 8770 TRANSIT RD E AMHERST, NY 14051 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $366 | — | $366 | 0.40% |
| WAYNE MONROE DRYE3 | 2 RAVINIA DRIVE SUITE 1500 ATLANTA, GA 30346 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $14 | — | $14 | 0.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN, INC. | 93033 NETWORK PL CHICAGO, IL 60673 | VISION SERVICE PLAN | $3K | — | $3K | 2.95% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN, INC. | C/O JP MORGAN CHASE 93033 NETWORK PL CHICAGO, IL 60673 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE CO. | $1K | $220 | $2K | 12.08% |
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 | 649 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 48 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 708 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF WESTERN NEW YORK | 815 | $5.3M |
| Dental | GUARDIAN | 620 | $424K |
| Vision | VISION SERVICE PLAN | 530 | $89K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 649 | $233K |
| Short-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 649 | $233K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 649 | $140K |
| Prescription drug | BLUECROSS BLUESHIELD OF WESTERN NEW YORK | 815 | $5.1M |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 649 | $247K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 815 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.