| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $165K | — | $165K | 3.71% |
| SEDGWICK CLAIMS MANAGEMENT SERVICES5 Filed as: SEDGWICK CLAIMS MGMT SERVICES, INC. | 2620 THOUSAND OAKS BLVD. MEMPHIS, TN 15233 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $2.3M | $2.3M | 71.57% |
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $151K | — | $151K | 4.66% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON PR INS BRK INC | 530 AVE. CONSTITUCION SUITE 310 SAN JUAN, PR 009012304 | TRIPLE S SALUD, INC. | $49K | — | $49K | 4.95% |
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | KAISER FOUNDATION HEALTH PLAN, INC. | $19K | — | $19K | 3.39% |
| SEDGWICK CLAIMS MANAGEMENT SERVICES5 Filed as: SEDGWICK CLAIMS MGMT SERVICES, INC. | 2620 THOUSAND OAKS BLVD. MEMPHIS, TN 15233 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $45K | $45K | 71.57% |
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 4.66% |
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 | 16,312 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 127 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 16,439 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | TRIPLE S SALUD, INC. | 99 | $1.7M |
| Dental(3 contracts, 2 carriers) | TRIPLE S SALUD, INC. | 3,005 | $1.7M |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 8,718 | $4.5M |
| Long-term disability(2 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 7,703 | $3.3M |
| Prescription drug | TRIPLE S SALUD, INC. | 99 | $995K |
| Other(4 contracts, 2 carriers) | TRIPLE S SALUD, INC. | 3,005 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 8,718 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.