| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LIAZON BENEFITS INC3 | 199 SCOTT ST 8TH FLOOR BUFFALO, NY 14204 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $19 | $19K | $19K | 2.46% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF FLORIDA INC | 4211 W BOY SCOUT BLVD STE 1000 TAMPA, FL 33607 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $8K | $8K | 0.99% |
| LIAZON BENEFITS INC3 Filed as: LIAZON BENEFITS, INC | 199 SCOTT ST 8TH FLOOR BUFFALO, NY 14204 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $10K | $10K | 5.83% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE INC | PO BOX 505210 ST LOUIS, MO 63150 | SUN LIFE ASSURANCE COMPANY OF CANADA | $17K | — | $17K | 13.37% |
| LIAZON BENEFITS INC3 | 199 SCOTT ST 8TH FLOOR BUFFALO, NY 14204 | SUN LIFE ASSURANCE COMPANY OF CANADA | $7K | — | $7K | 5.36% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA | PO BOX 101162 PASADENA, CA 91189 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $1K | $1K | 0.94% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF FL INC | 4211 WEST BOY SCOUT BLVD STE 1000 TAMPA, FL 33607 | SYMETRA LIFE INSURANCE COMPANY | $10K | $2K | $13K | 12.30% |
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 | 1,114 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 114 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,232 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,978 | $169K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,978 | $169K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $765K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $765K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $765K |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 641 | $997K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,978 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.