| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | ONE WORLD FINANCIAL CENTER 200 LIBERTY ST, 7TH FL NEW YORK, NY 10281 | HARTFORD LIFE AND ACCIDENT | $178K | — | $178K | 7.43% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 801 S. FIGUEROA STREET SUITE 800 LOS ANGELES, CA 90017 | HARTFORD LIFE AND ACCIDENT | — | $36K | $36K | 1.52% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | 200 N WARNER RD STE 300 KING OF PRUSSIA, PA 19406 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $241K | — | $241K | 13.59% |
| BRENDAN C NAUGHTON3 Filed as: BRENDAN C. NAUGHTON | 330 WHITNEY AVE, STE 600 HOLYOKE, MA 01040 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $42K | $495 | $42K | 2.39% |
| PETER S NOVAK3 Filed as: PETER S. NOVAK | 42 CORD GRASS CT FERNANDINA BEACH, FL 32034 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $6K | — | $6K | 0.32% |
| CORPORATE SYNERGIES GROUP LLC3 | 2 AQUARIUM DR., STE 200 CAMDEN, NJ 08103 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $3K | — | $3K | 0.18% |
| HARRIS S. FISHMAN3 | 1000 CORPORATE DR. STE 700 FORT LAUDERDALE, FL 33334 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $2K | — | $2K | 0.11% |
| NICHOLAS J ORPHAN3 | 505 WINFIELD GLEN CT NE ATLANTA, GA 30342 | MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY | $9 | — | $9 | 0.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | P.O. BOX 4557 NEW YORK, NY 10249 | AETNA LIFE INSURANCE CO. | $56K | $20K | $76K | 5.47% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | 1 WORLD FINANCIAL CENTER 200 LIBERTY STREET NEW YORK, NY 10281 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $12K | — | $12K | 3.42% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | 200 LIBERTY STREET NEW YORK, NY 10281 | VISION BENEFITS OF AMERICA | $2K | — | $2K | 2.40% |
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 | 1,915 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 42 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 47 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,004 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | 35 | $348K |
| Dental | AETNA LIFE INSURANCE CO. | 3,158 | $1.4M |
| Vision | VISION BENEFITS OF AMERICA | 1,415 | $100K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 2,048 | $2.4M |
| Long-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 2,048 | $4.2M |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | 35 | $348K |
| Other | HARTFORD LIFE AND ACCIDENT | 2,048 | $2.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,158 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.