| 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 | $24K | $18K | $42K | 3.82% |
| 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 | $34K | — | $34K | 3.50% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 LOCKBOX 28852 NEW YORK, NY 10087 | HARTFORD LIFE AND ACCIDENT | — | $107 | $107 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 NONE | Claims processing; Other services Service code 12 | — | $623K |
| THE PRUDENTIAL INS.CO. OF AMERICA EIN 22-1211670 NONE | Plan Administrator; Other fees Service code 14 | — | $57K |
| 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 | 1,146 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 75 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,221 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 2,401 | $1.1M |
| Vision | VISION SERVICE PLAN | 820 | $159K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,763 | $961K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,763 | $961K |
| Stop-loss / reinsurancereinsurance | UNITEDHEALTHCARE INSURANCE COMPANY | 2,758 | $348K |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,763 | $961K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,758 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.