| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW JERSEY INC | 150 JOHN F KENNEDY PARKWAY, SUITE 52, PO BOX 5002 SHORT HILLS, NJ 07078 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $923 | $923 | 0.88% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $625 | $625 | 0.59% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW JERSEY INC | 150 JOHN F KENNEDY PARKWAY, SUITE 52, PO BOX 5002 SHORT HILLS, NJ 07078 | FIRST UNUM LIFE INSURANCE COMPANY | — | $34 | $34 | 0.83% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | FIRST UNUM LIFE INSURANCE COMPANY | — | $28 | $28 | 0.69% |
| MCINNIS INS & FIN SVCS3 | 410 SW MACADAM AVENUE, SUITE 210 PORTLAND, OR 97239 | STANDARD INSURANCE COMPANY | -$51 | — | -$51 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNUM LIFE INSURANCE CO. OF AMERICA EIN 01-0278678 STD ADMINISTRATOR | Contract Administrator Service code 13 | — | $20K |
| LIFEWORKS US INC. EIN 52-1883918 EAP ADMINISTRATOR | Contract Administrator Service code 13 | — | $8K |
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 | 560 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 560 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Short-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 19 | $4K |
| Long-term disability(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 518 | $110K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 518 | — |
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.