| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LIAZON BENEFITS INC3 | 199 SCOTT STREET BUFFALO, NY 14204 | AETNA LIFE INSURANCE CO | $3K | — | $3K | 0.25% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 775 YARD ST STE 200 COLUMBUS, OH 43212 | METROPOLITAN LIFE INSURANCE COMPANY | $15K | $61 | $15K | 9.34% |
| LIAZON BENEFITS INC5 | 199 SCOTT ST FL 8 BUFFALO, NY 14204 | METROPOLITAN LIFE INSURANCE COMPANY | — | $8K | $8K | 4.99% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO INC | 775 YARD ST STE 200 COLUMBUS, OH 43212 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $3K | $6K | 3.58% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO | ATTN 93245 131 S DEARBORN 6TH FL CHICAGO, IL 60603 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $775 | — | $775 | 9.86% |
| LIAZON BENEFITS INC3 Filed as: LIAZON CORPORATION - EXCHANGE | 199 SCOTT ST, 8TH FL BUFFALO, NY 14204 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $387 | — | $387 | 4.92% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WILLIS OF OHIO INC BROKER | Insurance services; Direct payment from the plan; Insurance agents and brokers Service code 22 | 775 YARD ST COLUMBUS, OH 43212 | $30K |
| WILLIS TOWERS WATSON MIDWEST INC BROKER | Insurance services; Insurance agents and brokers; Direct payment from the plan Service code 22 | 775 YARD ST COLUMBUS, OH 43212 | $11K |
| WILLIS TOWERS WATSON INC EIN 34-1174529 BROKER | Insurance agents and brokers; Insurance services; Direct payment from the plan Service code 22 | — | $0 |
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 | 125 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 131 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO | 162 | $1.1M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 235 | $161K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 117 | $8K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 235 | $161K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 235 | $161K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 235 | $161K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 235 | $161K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 235 | — |
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.