| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF PENNSYLVANIA, INC. | 100 MATSONFORD RD FIVE RADNOR CORP. CTR, NO. 200 RADNOR, PA 19087 | INDEPENDENCE BLUE CROSS | $109K | — | $109K | 4.16% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF PENNSYLVANIA, INC. | 100 MATSONFORD RD FIVE RADNOR CORP. CTR, NO. 200 RADNOR, PA 19087 | KEYSTONE | $52K | — | $52K | 4.53% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF PENNSYLVANIA INC. | 5 RADNOR CORP. CTR, STE 200 100 MATSONFORD RD RADNOR, PA 19087 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $22K | $7K | $29K | 13.44% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF PENNSYLVANIA INC. | PO BOX 905196 CHARLOTTE, NC 282905432 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | $4K | $13K | 7.26% |
| RUBEN GONZALEZ3 | 5050 N. 40TH ST, STE 100 PHOENIX, AZ 850182146 | METROPOLITAN LIFE INSURANCE COMPANY | $10 | — | $10 | 0.01% |
| CHARLES W BROUCEK3 Filed as: CHARLES HALL | 5050 N. 40TH ST, STE 100 PHOENIX, AZ 850182146 | METROPOLITAN LIFE INSURANCE COMPANY | $8 | — | $8 | 0.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF PENNSYLVANIA INC. | PO BOX 905196 CHARLOTTE, NC 282905196 | VISION SERVICE PLAN | $2K | — | $2K | 4.28% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | ONE WORLD FINANCIAL CENTER 200 LIBERTY STREET NEW YORK, NY 10281 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $190 | $7 | $197 | 20.74% |
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 | 238 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 239 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | INDEPENDENCE BLUE CROSS | 344 | $3.8M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 839 | $185K |
| Vision | VISION SERVICE PLAN | 221 | $36K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 220 | $219K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 220 | $219K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 220 | $219K |
| Prescription drug | INDEPENDENCE BLUE CROSS | 344 | $2.6M |
| Other(3 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 238 | $232K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 839 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.