| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 | 555 17TH ST STE 2050 DENVER, CO 80202 | SYMETRA LIFE INSURANCE COMPANY | $0 | $44K | $44K | 1.80% |
| WILLIS TOWERS WATSON US LLC3 | LOCK BOX 28852 PO BOX 28852 NEW YORK, NY 10087 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $64K | $7K | $71K | 5.54% |
| WILLIS TOWERS WATSON US LLC3 | LOCK BOX 28852 PO BOX 28852 NEW YORK, NY 10087 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $181K | $7K | $188K | 20.78% |
| WILLIS TOWERS WATSON US LLC3 | LOCK BOX 28852 PO BOX 28852 NEW YORK, NY 10087 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $36K | $7K | $43K | 5.98% |
| WILLIS TOWERS WATSON US LLC3 | LOCK BOX 28852 PO BOX 28852 NEW YORK, NY 10087 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $31K | $3K | $34K | 16.42% |
| WILLIS TOWERS WATSON US LLC3 | LOCK BOX 28852 PO BOX 28852 NEW YORK, NY 10087 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | $766 | $7K | 16.96% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | WILLIS OF ILLINOIS, INC-INNOTECH 233 S WACKER DR. STE 2000 CHICAGO, IL 60606 | FIRST UNUM LIFE INSURANCE COMPANY | $7K | — | $7K | 46.89% |
| SYNERGY ENROLLMENT AND BENEFITS LLC3 | 3550 CAMINO DEL RIO N STE 207 SAN DIEGO, CA 92108 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $903 | $50 | $953 | 13.51% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | ALISO VIEJO P.O. BOX 95287 CHICAGO, IL 60694 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $372 | — | $372 | 5.27% |
| MS BENEFITS3 | 100 CHALLENGER ROAD RIDGEFIELD PARK, NJ 07660 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $289 | — | $289 | 4.10% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 9855 SCRANTON ROAD SUITE 100 SAN DIEGO, CA 92121 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $216 | — | $216 | 3.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INSURANCE | SERVICES INC STE 300 3390 UNIVERSITY AVE RIVERSIDE, CA 92501 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $43 | $43 | 0.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD 11TH FLOOR ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $15 | $15 | 0.21% |
| EMPLOYEE FAMILY PROTECTION INC3 Filed as: EMPLOYEE FAMILY PROTECTION INC. | ATTN MICHAEL STEPNOWSKI PO BOX 1237 GLASTONBURY, CT 06033 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $203 | — | $203 | 5.62% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | ATTN ERICA MENDEZ 701 B ST STE 600 SAN DIEGO, CA 92101 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $79 | — | $79 | 2.19% |
| SMITH, THOMAS, CHRISTOPHER3 | PO BOX 40386 798 BERRY RD NASHVILLE, TN 37204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $17 | — | $17 | 0.47% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | WILLIS OF ILLINOIS, INC. - INNOTECH 233 S WACKER DR. STE 2000 CHICAGO, IL 60606 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6 | — | $6 | 0.17% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $70 | $70 | 2.20% |
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 | 2,745 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 39 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,791 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF NEW JERSEY, INC. | 5,746 | $2.6M |
| Vision(2 contracts) | EYEMED VISION CARE | 5,611 | $161K |
| Life insurance(4 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 3,240 | $944K |
| Short-term disability(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 552 | $910K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,119 | $1.3M |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 2,713 | $2.4M |
| Other(4 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 3,240 | $763K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,746 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.