| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | P.O. BOX 4557 NEW YORK, NY 10249 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $115 | $131K | $132K | 3.53% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | P.O. BOX 4557 NEW YORK, NY 10249 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 2.59% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | 200 LIBERTY ST NEW YORK, NY 10281 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $14K | — | $14K | 6.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | P.O. BOX 101162 PASADENA, CA 91189 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $5K | $5K | 2.17% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $78 | $78 | 0.03% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | P.O. BOX 4557 NEW YORK, NY 10249 | AETNA LIFE INSURANCE CO. | $4K | $3K | $7K | 8.66% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS COMPANY | 400 BERWYN PARK, SUITE 200 899 CASSATT ROAD BERWYN, PA 19312 | UNITED CONCORDIA INSURANCE COMPANY | $3K | — | $3K | 4.31% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | 1 WORLD FINANCIAL CTR, FL. 6 NEW YORK, NY 10281 | VISION SERVICE PLAN | $1K | — | $1K | 5.45% |
| KISTLER TIFFANY BENEFITS3 Filed as: KISTLER TIFFANY BENEFITS COMPANY | 400 BERWYN PARK, SUITE 200 899 CASSATT ROAD BERWYN, PA 19312 | UNITED CONCORDIA DENTAL PLANS, INC. | $488 | — | $488 | 4.22% |
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 | 368 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 368 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 224 | $3.7M |
| Dental(3 contracts, 3 carriers) | AETNA LIFE INSURANCE CO. | 210 | $165K |
| Vision(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 224 | $3.7M |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 371 | $229K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 368 | $240K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 224 | $3.7M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 371 | $229K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 371 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.