| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| C2 CENTRIC LLC3 | P.O. BOX 6824 GRAND RAPIDS, MI 49516 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $14K | $14K | 0.73% |
| C2 CENTRIC LLC3 | P.O. BOX 6824 GRAND RAPIDS, MI 49516 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $266 | $266 | 0.29% |
| CONNER STRONG & BUCKELEW3 | TRIAD1828 CENTRE, 2 COOPER STREET P.O. BOX 99106 CAMDEN, NJ 08101 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $4K | — | $4K | 15.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS.SRVC W.INC | 15305 N DALLAS PKWY, STE. 1100 COLONNADE III ADDISON, TX 75001 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | -$82 | — | -$82 | — |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROCKERAGE, INC. | 160 FEDERAL STREET BOSTON, MA 02110 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | -$300 | — | -$300 | — |
| SCHNITTKER, REED, HEADLEY3 | 2400 DALLAS PKWY, STE 430 PLANO, TX 75093 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | -$338 | — | -$338 | — |
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 | 2,536 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 75 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,611 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 40 | $340K |
| Dental(2 contracts) | DELTA DENTAL OF PENNSYLVANIA | 3,816 | $1.9M |
| Vision(3 contracts) | EYEMED VISION CARE (FIDELITY SECURITY LIFE INSURANCE COMPANY) | 3,952 | $291K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 2,536 | $1.9M |
| Short-term disability(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 294 | $92K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 2,536 | $1.9M |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 40 | $340K |
| Other(3 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 2,536 | $2.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,952 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.