| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 | COM LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | SECURIAN LIFE INSURANCE COMPANY | — | $59K | $59K | 2.26% |
| WILLIS TOWERS WATSON US LLC3 | COM LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | SECURIAN LIFE INSURANCE COMPANY | — | $9K | $9K | 2.26% |
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 P.O. BOX 28852 NEW YORK, NY 10087 | HYATT LEGAL PLANS | $29K | $7K | $36K | 12.47% |
| LOCKTON COMPANIES, LLC3 | 525 WEST MONROE STREET, SUITE 600 CHICAGO, IL 60661 | HYATT LEGAL PLANS | — | $73 | $73 | 0.03% |
| WILLIS TOWERS WATSON US LLC3 | COM LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | SECURIAN LIFE INSURANCE COMPANY | — | $6K | $6K | 2.25% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK NORTHEAST, INC. | 200 LIBERTY STREET, 7TH FLOOR NEW YORK, NV 10281 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | $19K | — | $19K | 25.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK NORTHEAST, INC | 200 LIBERTY STREET, 7TH FLOOR NEW YORK, NY 10281 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | $14K | — | $14K | 25.00% |
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 | 10,594 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 252 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1,081 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 11,927 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF HAWAII | 5 | $62K |
| Vision(2 contracts) | EYEMED VISION CARE | 15,589 | $1.2M |
| Life insurance | SECURIAN LIFE INSURANCE COMPANY | 13,666 | $2.6M |
| Long-term disability | LIFE INSURANCE OF NORTH AMERICA | 9,731 | $2.9M |
| Other(6 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF AMERICA | 10,722 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 15,589 | — |
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.