| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 730054 DALLAS, TX 75373 | UNITEDHEALTHCARE INSURANCE COMPANY | $136K | — | $136K | 3.53% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: CRAGIN & PIKE INC | 10000 W CHARLESTON BLVD, STE 200 LAS VEGAS, NV 89135 | UNITEDHEALTHCARE INSURANCE COMPANY | $10K | — | $10K | 0.25% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | 2000 SOUTH COLORADO BOULEVARD TOWER II, SUITE 900 DENVER, CO 80246 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $42K | — | $42K | 7.61% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS - SEE ATTACHMENT | PO BOX 427 COLUMBIA, SC 29202 | CONTINENTAL AMERICAN INSURANCE COMPANY | $22K | — | $22K | 33.51% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 730054 DALLAS, TX 75373 | UNITEDHEALTHCARE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 1144 W WASHINGTON ST TEMPA, AZ 85288 | UNITEDHEALTHCARE INSURANCE COMPANY | $399 | — | $399 | 10.01% |
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 | 285 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 8 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 296 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts) | UNITEDHEALTHCARE INSURANCE COMPANY | 600 | $3.9M |
| Dental(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 358 | $567K |
| Vision(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 358 | $567K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 358 | $553K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 358 | $553K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 358 | $553K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 600 | $3.8M |
| Other(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 581 | $628K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 600 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.