| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | ONE WORLD FINANCIAL CENTER 200 LIBERTY ST NEW YORK, NY 10281 | HIGHMARK INC. | $21K | — | $21K | 1.82% |
| MARSH & MCLENNAN AGENCY LLC3 | 101 N STARCREST DR CLEARWATER, FL 33765 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $250 | — | $250 | 3.40% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW JERSEY INC | PO BOX 416315 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $118 | — | $118 | 1.61% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW JERSEY, INC. | PO BOX 416315 BOSTON, MA 02241 | EYEMED VISION CARE OBO THE FIDELITY SECURITY LIFE INSURANCE COMPANY | $574 | — | $574 | 8.46% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: BOUCHARD INS, A MARSH/MCLENNAN AGCY | 101 N STARCREST DR CLEARWATER, FL 33765 | EYEMED VISION CARE OBO THE FIDELITY SECURITY LIFE INSURANCE COMPANY | $48 | — | $48 | 0.71% |
| MARSH & MCLENNAN AGENCY LLC3 | 101 N STARCREST DR CLEARWATER, FL 33765 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $665 | — | $665 | 10.17% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW JERSEY INC | PO BOX 416315 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $320 | — | $320 | 4.89% |
| MARSH & MCLENNAN AGENCY LLC3 | 101 N STARCREST DR CLEARWATER, FL 33765 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $250 | — | $250 | 4.75% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW JERSEY INC | PO BOX 416315 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $120 | — | $120 | 2.28% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW JERSEY INC | 150 JOHN F KENNEDY PKWY, STE 52 PO BOX 5002 SHORT HILLS, NJ 07078 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $211 | $26 | $237 | 9.10% |
| MARSH & MCLENNAN AGENCY LLC3 | 101 N STARCREST DR CLEARWATER, FL 33765 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $25 | $2 | $27 | 1.04% |
| MARSH & MCLENNAN AGENCY LLC3 | 101 N STARCREST DR CLEARWATER, FL 33765 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $18 | — | $18 | 3.36% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW JERSEY INC | PO BOX 416315 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8 | — | $8 | 1.50% |
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 | 101 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 101 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK INC. | 98 | $1.1M |
| Vision | EYEMED VISION CARE OBO THE FIDELITY SECURITY LIFE INSURANCE COMPANY | 122 | $7K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 101 | $10K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 101 | $7K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 101 | $5K |
| Prescription drug | HIGHMARK INC. | 98 | $1.1M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 101 | $535 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 122 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.