| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO INC | 775 YARD STREET COLUMBUS, OH 43212 | AETNA LIFE INSURANCE CO. | $14K | — | $14K | 3.39% |
| TBG WEST INSURANCE SERVICES3 | 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $23K | $5K | $28K | 10.20% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO INC | 2245 N. BANK DR COLUMBUS, OH 43220 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $10K | $5K | $16K | 11.35% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO | 1001 LAKESIDE AVE STE 1600 CLEVELAND, OH 44114 | HEALTHSPAN INTEGRATED CARE | $1K | — | $1K | 3.38% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO INC | 93245 NETWORK PLACE CHICAGO, IL 606731932 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 10.31% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILIS INSURANCE SERVICES OF CA INC | PO BOX 100003 PASADENA, CA 91189 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $276 | — | $276 | 0.98% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO INC-CLEVELAND | 93245 NETWORK PLACE CHICAGO, IL 606730001 | COMPBENEFITS INSURANCE COMPANY | $3K | — | $3K | 10.76% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERIVES OF GA | 1 GLENLAKE PKWY 11TH FL ATLANTA, GA 30328 | COMPBENEFITS INSURANCE COMPANY | — | $241 | $241 | 0.92% |
| PECK FINANCIAL SERVICES INC3 Filed as: PECK, RANDALL, WARREN | 950 PENINSULA CORP CIR STE 1000 BOCA RATON, FL 33487 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $909 | $2K | 8.70% |
| TBG WEST INSURANCE SERVICES3 | 6077 BRISTOL PARKWAY CULVER CITY, CA 90230 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $103 | $205 | $308 | 1.26% |
| PECK FINANCIAL SERVICES INC3 Filed as: PECK, RANDALL, WARREN | 950 PENINSULA CORP CIR STE 1000 BOCA RATON, FL 33487 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $614 | $245 | $859 | 15.72% |
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 | 392 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 396 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 382 | $412K |
| Dental | AETNA LIFE INSURANCE CO. | 382 | $412K |
| Vision | COMPBENEFITS INSURANCE COMPANY | 154 | $26K |
| Life insurance(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 275 | $166K |
| Long-term disability(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 301 | $302K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 396 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.