| 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 | $128K | — | $128K | 2.57% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $75K | — | $75K | 1.51% |
| IMG5 | 2960 NORTH MERIDIAN ST INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 0.03% |
| JOHN MULLEN & COMPANY5 Filed as: JOHN MULLEN & CO | PO BOX 2096 HONOLULU, HI 36805 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $524 | $524 | 0.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST | 12505 PARK POTOMAC AVE #300 POTOMAC, MD 20854 | SYMETRA LIFE INSURANCE COMPANY | — | $78K | $78K | 3.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | PO BOX101162 PASADENA, CA 91189 | CIGNA LIFE AND HEALTH INSURANCE COMPANY | $199K | — | $199K | 10.34% |
| 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. | $36K | — | $36K | 3.09% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SERV | 13065 COLLECTIONS CTR DR CHICAGO, IL 60693 | BLUECROSS BLUESHIELD OF NEW MEXICO | $10K | — | $10K | 2.99% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST | 225 SCHILLING CIRCLE #150 HUNT VALLEY, MD 21031 | GUARDIAN | $18K | $1K | $19K | 8.55% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST | 225 SCHILLING CIRCELE #150 HUNT VALLEY, MD 21031 | GUARDIAN | $21K | $878 | $22K | 11.94% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | PO BOX 13784 NEWARK, NJ 07188 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE CO. | $16K | $1K | $18K | 10.49% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE, INC. | 265 BROOKVIEW CENTER WAY KNOXVILEE, TN 37919 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE CO. | — | $507 | $507 | 0.30% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE INC | 4565 PAYSHPERE CIRCLE CHICAGO, IL 60674 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE CO. | — | $63 | $63 | 0.04% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST | PO BOX 101162 PASADENA, CA 91189 | HARTFORD ACCIDENT AND LIFE INSURANCE CO | $2K | — | $2K | 5.58% |
| 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 | $632 | — | $632 | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM HEALTH PLANS OF VIRGINIA, IN EIN 54-0357120 TPA | Other services; Claims processing; Contract Administrator; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $3.0M |
| PRUDENTIAL INSURANCE CO OF AMERICA EIN 22-1211670 TPA | Consulting fees; Contract Administrator Service code 13 | — | $119K |
| TELUS HEALTH LTD EIN 52-1883918 EAP PROVIDER | Other services Service code 49 | — | $40K |
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 | 4,647 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 4,647 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 5 carriers) | CIGNA LIFE AND HEALTH INSURANCE COMPANY | 312 | $3.5M |
| Dental(4 contracts, 3 carriers) | DELTA DENTAL OF NORTH CAROLINA | 8,974 | $11.9M |
| Vision(3 contracts, 2 carriers) | VSP | 3,980 | $869K |
| Life insurance(3 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 7,135 | $5.4M |
| Short-term disability(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 7,135 | $5.2M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 7,135 | $5.0M |
| Prescription drug | HIGHMARK WESTERN AND NORTHEASTERN NEW YORK INC. | 103 | $1.2M |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 3,791 | $3.7M |
| Other(4 contracts, 3 carriers) | CIGNA LIFE AND HEALTH INSURANCE COMPANY | 883 | $2.5M |
| 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.