| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | PO BOX 28852 NEW YORK, NY 100878852 | METROPOLITAN LIFE INSURANCE COMPANY | $803 | $919 | $2K | 4.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERVICES USA INC | 1018 W 9TH AVE. KING OF PRUSSIA, PA 194061225 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $450 | $450 | 1.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERVICES USA INC. | 1350 TREAT BLVD STE 550 WALNUT CREEK, CA 945977999 | METROPOLITAN LIFE INSURANCE COMPANY | $7 | $4 | $11 | 0.03% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | PO BOX 28852 NEW YORK, NY 100878852 | METROPOLITAN LIFE INSURANCE COMPANY | $136 | $138 | $274 | 5.18% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERVICES USA INC. | 1018 W 9TH AVE KING OF PRUSSIA, PA 194061225 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $65 | $65 | 1.23% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERVICES USA INC. | 1350 TREAT BLVD STE 550 WALNUT CREEK, CA 945977999 | METROPOLITAN LIFE INSURANCE COMPANY | $5 | $4 | $9 | 0.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERVICES USA INC | 1350 TREAT BLVD, STE 550 WALNUT CREEK, CA 945977999 | METROPOLITAN LIFE INSURANCE COMPANY | $63 | — | $63 | 1.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERVICES USA INC | 1018 W 9TH AVE KING OF PRUSSIA, PA 194061225 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $50 | $50 | 0.99% |
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 | 502 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 510 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | KAISER FOUNDATION HEALTH PLAN OF COLORADO | 28 | $453K |
| Dental | AETNA LIFE INSURANCE CO. | 150 | $71K |
| Vision | COMBINED INSURANCE COMPANY OF AMERICA | 1,474 | $12K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 526 | $39K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 53 | $5K |
| Other(2 contracts, 2 carriers) | HYATT LEGAL PLANS | 526 | $52K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,474 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.