| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF CONNECTICUT | 185 ASYLUM STREET 25TH FLOOR HARTFORD, CT 06103 | DELTA DENTAL OF NJ, INC. | $1K | — | $1K | 0.74% |
| BAXTER H MAFFETT3 | 100 PEARL ST 3RD FLOOR-WEST TOWER HARTFORD, CT 061034506 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $5K | $1K | $6K | 14.07% |
| PETER S NOVAK3 | 330 WHITNEY AVE STE 600 HOLYOKE, MA 01040 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $1K | $4K | $5K | 12.55% |
| DANIEL F MCCARTHY3 | 100 PEARL STREET FL 3 W TOWER HARTFORD, CT 061034510 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $5K | $508 | $5K | 12.55% |
| BRENDAN C NAUGHTON3 | 501 MERRITT 7 5TH FLOOR NORWALK, CT 068517002 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $406 | — | $406 | 0.99% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF CONNECTICUT | 185 ASYLUM STREET 25TH FLOOR HARTFORD, CT 06103 | DELTA DENTAL OF NJ, INC. | $2K | — | $2K | — |
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 | 3,774 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 88 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,862 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM HEALTH PLANS, INC. (G1800) | 86 | $405K |
| Dental(4 contracts) | DELTA DENTAL OF NJ, INC. | 5,294 | $8.5M |
| Vision | EYEMED VISION CARE ON BEHALF OF COMBINED INSURANCE COMPANY OF AMERICA | 2,261 | $140K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 3,000 | $360K |
| Long-term disability(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 16,658 | $3.8M |
| Other | HARTFORD LIFE AND ACCIDENT | 3,000 | $360K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 16,658 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.