| 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 | — | $39K | $39K | 2.29% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | COMMISSION LOCKBOX 28852 NEW YORK, NY 100878852 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $32K | $32K | 2.12% |
| WILLIS TOWERS WATSON US LLC3 | COM LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | SECURIAN LIFE INSURANCE COMPANY | — | $20K | $20K | 2.29% |
| WILLIS TOWERS WATSON US LLC3 | COM LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | SECURIAN LIFE INSURANCE COMPANY | — | $4K | $4K | 2.24% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 PLAN ADMINISTRATOR | Contract Administrator; Claims processing; Other services; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | MAIL DROP OH3403 A266 3075 VANDERCAR WAY CINCINNATI, OH 45209 | $2.7M |
| AETNA BEHAVIORAL HEALTH, LLC EIN 20-0446713 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | 151 FARMINGTON AVENUE RSAA HARTFORD, CT 06156 | $145K |
| HEALTH AND HUMAN RESOURCE CENTER EIN 33-0052273 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | 151 FARMINGTON AVENUE RSAA HARTFORD, CT 06156 | $5K |
| TOWERS WATSON DELAWARE INC PLAN ADMINISTRATOR | Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | 28411 NORTHWESTERN HIGHWAY STE 500 SOUTHFIELD, MI 48034 | $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 | 7,209 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,907 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 9,116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | GEISINGER HEALTH PLAN | 661 | $5.8M |
| Vision | VISION SERVICE PLAN | 4,816 | $1.4M |
| Life insurance(3 contracts) | SECURIAN LIFE INSURANCE COMPANY | 8,141 | $2.8M |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 6,392 | $1.5M |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE COMPANY (ANTHEM) | 5,570 | $1.2M |
| Other(3 contracts, 3 carriers) | AETNA BEHAVIORAL HEALTH LLC | 19,421 | $181K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 19,421 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.