| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON PENNSYLVANIA INC. | PO BOX 8500 LOCKBOX 9102 PHILADELPHIA, PA 19178 | RELIASTAR LIFE INSURANCE COMPANY | $0 | $49K | $49K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXPRESS SCRIPTS, INC. EIN 22-3461740 NONE | Contract Administrator Service code 13 | — | $243K |
| J.P MORGAN CHASE BANK, N.A. EIN 13-4994650 NONE | Shareholder servicing fees; Float revenue; Investment management fees paid indirectly by plan; Non-monetary compensation; Distribution (12b-1) fees; Other investment fees and expenses; Securities brokerage commissions and fees Service code 52 | 4 NEW YORK PLAZA 12TH FLOOR NEW YORK, NY 10004 | $0 |
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 | 3,134 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 781 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,915 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF NJ, INC | 3,435 | $2.9M |
| Stop-loss / reinsurancereinsurance | RELIASTAR LIFE INSURANCE COMPANY | 3,465 | $985K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,465 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.