| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST, INC | PO BOX 4557 NEW YORK, NY 10249 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $20K | — | $20K | 7.63% |
| TITAN INSURANCE & EMPLOYEE BENEFITS3 | 1 SOUTH CLINTON AVENUE ROCHESTER, NY 14604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 2.37% |
| STEALTH PARTNER GROUP LLC3 Filed as: STEALTH PARTNER GROUP | 18940 NORTH PIMA ROAD SCOTTSDALE, AZ 85255 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $3K | $3K | 1.19% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | PO BOX 416672 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $307 | $307 | 0.12% |
| TITAN INSURANCE & EMPLOYEE BENEFITS3 | 1 SOUTH CLINTON AVENUE ROCHESTER, NY 14604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 1.32% |
| STEALTH PARTNER GROUP LLC3 Filed as: STEALTH PARTNER GROUP | 18940 NORTH PIMA ROAD SCOTTSDALE, AZ 85255 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $3K | $3K | 1.23% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST, INC | PO BOX 4557 NEW YORK, NY 10249 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 0.78% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | PO BOX 416672 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $154 | $154 | 0.07% |
| MICHAEL GUROWSKI3 | 24 RIVER BIRCH LANE WEBSTER, NY 14580 | TRUSTMARK INSURANCE COMPANY | $34K | — | $34K | 21.89% |
| US NATIONAL BENEFIT PARTNERS3 | 99 WOOD AVENUE SOUTH SUITE 501 ISELIN, NJ 08830 | TRUSTMARK INSURANCE COMPANY | $2K | — | $2K | 1.25% |
| TITAN INS & EMPLOYEE BENEFITS3 | 1 SOUTH CLINTON AVENUE ROCHESTER, NY 14604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 2.36% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST, INC | PO BOX 4557 NEW YORK, NY 10249 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 1.88% |
| STEALTH PARTNER GROUP LLC3 Filed as: STEALTH PARTNER GROUP | 18940 NORTH PIMA ROAD SCOTTSDALE, AZ 85255 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 1.23% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | PO BOX 416672 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $154 | $154 | 0.13% |
| TITAN INS & EMPLOYEE BENEFITS3 Filed as: TITAN INS AND EMPLOYEE BENEFIT | 1 SOUTH CLINTON AVENUE SUITE 1030 ROCHESTER, NY 14604 | SYMETRA LIFE INSURANCE COMPANY | $22K | $11K | $33K | 29.76% |
| US NATIONAL BENEFIT PARTNERS WEST3 Filed as: U.S. NATIONAL BENEFIT PARTNERS | 99 WOOD AVE SOUTH SUITE 501 ISELIN, NJ 08830 | SYMETRA LIFE INSURANCE COMPANY | — | $2K | $2K | 1.93% |
| ELM STREET CAPITAL LLC3 | 5906 CARDINAL LAKE DRIVE GREENSBORO, NC 27410 | SYMETRA LIFE INSURANCE COMPANY | — | $2K | $2K | 1.75% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS - SEE ATTACHMENT | 8750 W. BRYN MAWR AVE CHICAGO, IL 60631 | COMBINED INSURANCE COMPANY OF AMERICA | $20K | — | $20K | 21.46% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | 200 LIBERTY STREET NEW YORK, NY 10281 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $1K | $4K | 5.04% |
| TITAN INS & EMPLOYEE BENEFITS3 | 1 SOUTH CLINTON AVENUE SUITE 1030 ROCHESTER, NY 14604 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $614 | $1K | $2K | 2.34% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST, INC | PO BOX 4557 NEW YORK, NY 10249 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 7.41% |
| TITAN INSURANCE & EMPLOYEE BENEFITS3 | 1 SOUTH CLINTON AVENUE ROCHESTER, NY 14604 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 2.59% |
| STEALTH PARTNER GROUP LLC3 Filed as: STEALTH PARTNER GROUP | 18940 NORTH PIMA ROAD SCOTTSDALE, AZ 85255 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $789 | $789 | 1.30% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | PO BOX 416672 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $307 | $307 | 0.50% |
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 | 759 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 33 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 8 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 800 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 487 | $73K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 759 | $419K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 759 | $210K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 759 | $120K |
| Other(4 contracts, 4 carriers) | SYMETRA LIFE INSURANCE COMPANY | 759 | $277K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 759 | — |
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.