| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE, INC. | PO BOX 28852 NEW YORK, NY 100878852 | METROPOLITAN LIFE INSURANCE COMPANY | $23K | $19K | $42K | 3.63% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE, INC. | PO BOX 28852 COMMISSIONS LOCKBOX 28852 NEW YORK, NY 100878852 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $39K | — | $39K | 11.63% |
| HATTERAS3 | 56 PARK ROAD TINTON FALLS, NJ 07724 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $488 | $488 | 0.15% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWER WATSON DELAWARE, INC. | PO BOX 28852 NEW YORK, NY 100878852 | VISION SERVICE PLAN | $8K | — | $8K | 5.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | SUITE 1900 1001 LAKESIDE AVENUE CLEVELAND, OH 44114 | HARTFORD LIFE AND ACCIDENT | $800 | — | $800 | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 NONE | Other services; Claims processing Service code 12 | — | $777K |
| THE PRUDENTIAL INS.CO. OF AMERICA EIN 22-1211670 NONE | Other fees; Plan Administrator Service code 14 | — | $59K |
| TOWERS WATSON DELAWARE INC NONE | Other commissions Service code 55 | PO BOX 28852 LOCK BOX 28852 NEW YORK, NY 100878852 | $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 | 1,716 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,721 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 2,574 | $1.2M |
| Vision | VISION SERVICE PLAN | 904 | $168K |
| Life insurance(2 contracts, 2 carriers) | GRANGE LIFE INSURANCE COMPANY | 1,789 | $2.0M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 953 | $336K |
| Stop-loss / reinsurancereinsurance | UNITEDHEALTHCARE INSURANCE COMPANY | 2,863 | $373K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,863 | — |
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.