| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 13062 COLLECTIONS CENTER DR CHICAGO, IL 60693 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $79K | — | $79K | 1.96% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $52K | — | $52K | 1.29% |
| IMG5 | 2960 NORTH MERIDIAN ST INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $1K | $1K | 0.03% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST | 12505 PARK POTOMAC AVE #300 POTOMAC, MD 20854 | SYMETRA LIFE INSURANCE COMPANY | — | $129K | $129K | 6.20% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | PO BOX101162 PASADENA, CA 91189 | CIGNA LIFE AND HEALTH INSURANCE COMPANY | $159K | — | $159K | 9.96% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NE, INC | PO BOX 4557 NEW YORK, NY 10249 | HIGHMARK WESTERN AND NORTHEASTERN NEW YORK INC. | $26K | — | $26K | 2.08% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SERV | 13065 COLLECTIONS CENTRE DR CHICAGO, IL 60693 | BLUECROSS BLUESHIELD OF NEW MEXICO | $20K | — | $20K | 3.37% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | PO BOX 13784 NEWARK, NJ 07188 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE CO. | $13K | — | $13K | 10.25% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE, INC. | 29982 NETWORK PLACE CHICAGO, IL 60673 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE CO. | — | $1K | $1K | 0.96% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE INC | 265 BROOKVIEW CENTRE WAY #505 KNOXVILLE, TN 37919 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE CO. | — | $272 | $272 | 0.21% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 12505 PARK POTOMAC AVE SUITE 300 POTOMAC, MD 20854 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $663 | — | $663 | 9.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF VIRGINIA, IN EIN 54-0357120 TPA | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other services; Claims processing; Float revenue Service code 12 | — | $2.4M |
| TELUS HEALTH LTD EIN 52-1883918 EAP PROVIDER | Other services Service code 49 | — | $69K |
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 | 3,817 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 3,817 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(7 contracts, 6 carriers) | CIGNA LIFE AND HEALTH INSURANCE COMPANY | 204 | $3.5M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF NORTH CAROLINA | 8,974 | $11.2M |
| Vision | VSP | 3,408 | $391K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 6,598 | $4.0M |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 6,598 | $4.0M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 6,598 | $4.0M |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 3,607 | $3.3M |
| Other(2 contracts, 2 carriers) | CIGNA LIFE AND HEALTH INSURANCE COMPANY | 683 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 8,974 | — |
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."
No prospect flags tripped on this filing.