| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK, INC. | 200 LIBERTY STREET NEW YORK, NY 10281 | UNITEDHEALTHCARE INSURANCE COMPANY | $39K | — | $39K | 1.09% |
| WAYNE MONROE DRYE3 Filed as: WAYNE M DRYE | 6 CONCOURSE PARKWAY SUITE 3100 ATLANTA, GA 30328 | UNITEDHEALTHCARE INSURANCE COMPANY | $14K | — | $14K | 0.38% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK | 1 WORLD FINANCIAL CTR FLOOR 621 NEW YORK, NY 10281 | KAISER FOUNDATION HEALTH PLAN INC | $35K | — | $35K | 2.64% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK | 1 WORLD FINANCIAL CTR 200 LIBERTY ST 6TH FLOOR NEW YORK, NY 10281 | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | $9K | $6K | $16K | 3.67% |
| WAYNE MONROE DRYE3 Filed as: WAYNE M DRYE | 7000 CENTRAL PARKWAY SUITE 700 ATLANTA, GA 30328 | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | $4K | — | $4K | 0.98% |
| WAYNE MONROE DRYE3 Filed as: WAYNE DRYE | 6 CONCOURSE PARKWAY SUITE 3100 ATLANTA, GA 30326 | PRUDENTIAL | $9K | — | $9K | 4.05% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA INC | P.O. BOX 100003 PASADENA, CA 91189 | PRUDENTIAL | $2K | — | $2K | 0.90% |
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 | 702 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 6 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 715 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 1,052 | $5.0M |
| Dental | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | 994 | $427K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 1,052 | $3.6M |
| Life insurance | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | 994 | $427K |
| Short-term disability | PRUDENTIAL | 231 | $217K |
| Long-term disability | PRUDENTIAL | 231 | $217K |
| Other | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | 994 | $427K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,052 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.