| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MARYLAND INC. | PO BOX 13784 NEWARK, NJ 07188 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $30K | $6K | $36K | 7.06% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MARYLAND INC. | 6700 ROCKLEDGE DRIVE 5TH FLOOR BETHESDA, MD 20817 | HEALTHAMERICA OF PENNSYLVANIA, INC. | $9K | — | $9K | 9.09% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MARYLAND INC. | 12505 PARK POTOMAC AVE, SUITE 300 POTOMAC, MD 20854 | DELTA DENTAL OF PENNSYLVANIA | $5K | — | $5K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MARYLAND INC. | PO BOX 13784 NEWARK, NJ 07188 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $256 | $5K | 15.80% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS HRH- HUNT VALLEY, MD | 225 SCHILLING CIRCLE, STE 150 HUNT VALLEY, MD 21031 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 10.66% |
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 | 128 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 130 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | 120 | $758K |
| Dental | DELTA DENTAL OF PENNSYLVANIA | 210 | $54K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 180 | $18K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 128 | $32K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 128 | $32K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 128 | $32K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 128 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 210 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.