| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSONH DELAWARE INC | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | BERKLEY LIFE AND HEALTH INSURANCE COMPANY | $101K | $126K | $227K | 9.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA BEHAVIORAL HEALTH, INC EIN 41-1648670 BEHAVIORAL CARE PROVIDER | Float revenue; Claims processing; Direct payment from the plan; Participant communication; Other services; Contract Administrator Service code 12 | — | $648K |
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 | 13,255 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4,967 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 18,222 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | INDEPENDENT HEALTH | 270 | $2.0M |
| Dental | CONNECTICUT HEALTH AND LIFE INSURANCE COMPANY | 16 | $297K |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 18,219 | $4.9M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 8,758 | $2.8M |
| Stop-loss / reinsurancereinsurance | BERKLEY LIFE AND HEALTH INSURANCE COMPANY | 14,345 | $2.5M |
| Other | CONNECTICUT HEALTH AND LIFE INSURANCE COMPANY | 16 | $297K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 164,111 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.