| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | JP MORGAN CHASE P.O. BOX 4557 NEW YORK, NY 10249 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $13K | $76K | $90K | 4.58% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INS NOVEM BENEFITS | 350 LINDEN OAKS SUITE 140 ROCHESTER, NY 14625 | EXCELLUS BLUE CROSS BLUE SHIELD | $35K | — | $35K | 3.52% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | 3001 SUMMER STREET STAMFORD, CT 06905 | EXCELLUS BLUE CROSS BLUE SHIELD | $7K | — | $7K | 0.74% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INS NOVEM BENEFITS | 350 LINDEN OAKS SUITE 140 ROCHESTER, NY 14625 | EXCELLUS BLUE CROSS BLUE SHIELD | $5K | — | $5K | 7.99% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | 3001 SUMMER STREET STAMFORD, CT 06905 | EXCELLUS BLUE CROSS BLUE SHIELD | $570 | — | $570 | 0.98% |
| ENROLLEASE3 Filed as: DIGITAL INSURANCE AGENCY | 200 GALLERIA PKWY SE STE 1950 ATLANTA, GA 30339 | AMERITAS LIFE INSURANCE CORP. OF NEW YORK | $875 | — | $875 | 8.12% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | ONE WORLD FINANCIAL CENTER 200 LIBERTY ST NEW YORK, NY 10281 | AMERITAS LIFE INSURANCE CORP. OF NEW YORK | $202 | — | $202 | 1.88% |
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 | 160 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 160 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 211 | $2.9M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 211 | $2.0M |
| Vision(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 264 | $2.0M |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 211 | $2.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 264 | — |
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.