| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF PENNSYLVANIA | 100 MATSONFORD RD, BUILDING 5 WAYNE, PA 19087 | AULTCARE INSURANCE COMPANY | $17K | — | $17K | 1.79% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | 100 MATSONFORD ROAD BUILDING 5, SUITE 200 WAYNE, PA 19087 | HARTFORD LIFE AND ACCIDENT | $18K | — | $18K | 9.99% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 801 S FIGUEROA STREET SUITE 800 LOS ANGELES, CA 90017 | HARTFORD LIFE AND ACCIDENT | — | $2K | $2K | 1.21% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF PENNSYLVANIA, INC. | 100 MATSONFORD RD BLDG 5 WAYNE, PA 19087 | RELIASTAR LIFE INSURANCE COMPANY | $15K | — | $15K | 21.99% |
| EMPYREAN INSURANCE SERVICES, INC.3 Filed as: EMPYREAN INSURANCE SERVICES, INC | 9009 WEST LOOP S, STE 600 HOUSTON, TX 77096 | RELIASTAR LIFE INSURANCE COMPANY | — | $3K | $3K | 4.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | PO BOX 32090 NEW YORK, NY 10087 | VISION SERVICE PLAN | $9K | — | $9K | 16.32% |
| LIAZON BENEFITS INC3 Filed as: LIAZON BENEFITS, INC. | 199 SCOTT ST BUFFALO, NY 14204 | VISION SERVICE PLAN | $3K | — | $3K | 5.44% |
| EMPYREAN INSURANCE SERVICES, INC.3 Filed as: EMPYREAN INSURANCE SERVICES | 3010 BRIARPARK DR., STE 8000 HOUSTON, TX 77042 | VISION SERVICE PLAN | $2K | — | $2K | 2.94% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | ONE PPG PLACE STE 1000 PITTSBURGH, PA 15222 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 9.17% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | 401 LIBERTY AVE FL 22 PITTSBURGH, PA 15222 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $366 | $366 | 1.25% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | ONE PPG PLACE STE 1000 PITTSBURGH, PA 15222 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $424 | — | $424 | 5.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | 401 LIBERTY AVE FL 22 PITTSBURGH, PA 15222 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $106 | $106 | 1.25% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | 100 MATSONFORD ROAD BUILDING 2, SUITE 200 WAYNE, PA 19087 | HARTFORD LIFE AND ACCIDENT | $664 | — | $664 | 10.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 801 S FIGUEROA STREET SUITE 700 LOS ANGELES, CA 90017 | HARTFORD LIFE AND ACCIDENT | — | $58 | $58 | 0.87% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $143 | — | $143 | 15.05% |
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 | 545 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 145 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 692 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AULTCARE INSURANCE COMPANY | 141 | $973K |
| Vision | VISION SERVICE PLAN | 268 | $57K |
| Life insurance(3 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 513 | $218K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 513 | $180K |
| Other(7 contracts, 5 carriers) | HARTFORD LIFE AND ACCIDENT | 545 | $297K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 545 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.