| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | ONE WORLD FINANCIAL CENTER 200 LIBERTY ST, 6TH FL. NEW YORK, NY 10281 | BLUECROSS BLUESHIELD OF TEXAS | $80K | $3K | $83K | 3.21% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | 200 LIBERTY ST NEW YORK, NY 10281 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 5.59% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS W INC | P.O. BOX 101162 PASADENA, CA 91189 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 1.69% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $59 | $59 | 0.05% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | ONE WORLD FINANCIAL CTR 200 LIBERTY ST, 6TH FL. NEW YORK, NY 10281 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $1K | $6K | 5.29% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $6K | $224 | $7K | 14.60% |
| WILLIS TOWERS WATSON US LLC6 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | 800 BOYLSTON STREET BOSTON, MA 02199 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INS. COMPANY | $2K | — | $2K | 8.94% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $3K | $33 | $3K | 15.87% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $2K | $75 | $2K | 16.63% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $931 | — | $931 | 11.94% |
| IDENTITY THEFT CONSULTANTS LLC4 | 20480 166TH ST NW BIG LAKE, MN 55309 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $681 | — | $681 | 9.63% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | ONE WORLD FINANCIAL CENTER 200 LIBERTY ST, 6TH FL. NEW YORK, NY 10281 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $560 | — | $560 | 7.92% |
| TARA MOELLER4 | 16282 41ST ST BECKER, MN 55308 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $112 | — | $112 | 1.58% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $263 | — | $263 | 8.87% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $408 | — | $408 | 20.77% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $117 | — | $117 | 10.87% |
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 | 304 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 306 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TEXAS | 473 | $2.6M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 741 | $107K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INS. COMPANY | 492 | $26K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 309 | $109K |
| Short-term disability(7 contracts) | AFLAC | 52 | $90K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 309 | $109K |
| Prescription drug | BLUECROSS BLUESHIELD OF TEXAS | 473 | $2.6M |
| Other(8 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 309 | $206K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 741 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.