| 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 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $10K | — | $10K | 2.57% |
| PLANNED ADMINISTRATORS, INC.5 | 17 TECHNOLOGY CIRCLE SUITE E2AG COLUMBIA, SC 29203 | BCS INSURANCE COMPANY | — | $35K | $35K | 14.50% |
| INSURANCE APPLICATIONS GROUP3 | 220 N MAIN STREET GREENVILLE, SC 29601 | BCS INSURANCE COMPANY | $34K | — | $34K | 14.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC | 400 N EXECUTIVE DR STE 300 BROOKFIELD, WI 53005 | BCS INSURANCE COMPANY | $12K | — | $12K | 4.93% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC | 400 N EXECUTIVE DR SUITE 300 BROOKFIELD, WI 53005 | HARTFORD LIFE AND ACCIDENT | $14K | — | $14K | 8.27% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA | PO BOX 101162 PASADENA, CA 91189 | HARTFORD LIFE AND ACCIDENT | — | $4K | $4K | 2.55% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN | 2323 NORTH MAYFAIR ROAD SUITE 600 MILWAUKEE, WI 53226 | HARTFORD LIFE AND ACCIDENT | $647 | — | $647 | 0.38% |
| KEELER & ASSOCIATES3 | 2209 1ST AVE PLATTSMOUTH, NE 68048 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $42K | — | $42K | 26.24% |
| SHAWN J KEELER3 | 2209 1ST AVE PLATTSMOUTH, NE 68048 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $21K | — | $21K | 12.74% |
| JT-MARIKOS INS AGENCY INC3 | 200 WINTON RD NORTH ROCHESTER, NY 14610 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $9K | — | $9K | 5.33% |
| BENEFITSTORE INC3 | ATTN JENNIFER KEATING 100 BENEFITFOCUS WAY CHARLESTON, SC 29492 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $5K | — | $5K | 2.86% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN | 93033 NETWORK PLACE CHICAGO, IL 60673 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | — | $3K | 2.14% |
| JOHNATHAN GUAY3 | 1100 LONG POND RD SUITE 119 ROCHESTER, NY 14626 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 1.33% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 10087 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | — | $306 | $306 | 0.19% |
| WAYNE A LEVAN3 | 8770 TRANSIT RD E AMHERST, NY 14051 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $183 | — | $183 | 0.11% |
| WAYNE MONROE DRYE3 | 2 RAVINIA DRIVE SUITE 1500 ATLANTA, GA 30346 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $15 | — | $15 | 0.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN, INC. | 93033 NETWORK PL CHICAGO, IL 60673 | VISION SERVICE PLAN | $2K | — | $2K | 2.82% |
| 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 | $143 | $1K | 10.98% |
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 | 737 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 41 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 778 | 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 | 1,079 | $5.5M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 718 | $395K |
| Vision | VISION SERVICE PLAN | 587 | $88K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 363 | $331K |
| Short-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 363 | $331K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 363 | $170K |
| Prescription drug | BLUECROSS BLUESHIELD OF WESTERN NEW YORK | 1,079 | $5.2M |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 363 | $343K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,079 | — |
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.