| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS CORROON CORP OF AZ | 16220 N SCOTTSDALE ROAD STE 600 SCOTTSDALE, AZ 85254 | AETNA HEALTH INC. | $50K | — | $50K | 0.40% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SVCS USA INC | 600 HIGHWAY 169 SOUTH SUITE 1200 ST. LOUIS PARK, MN 55426 | AETNA HEALTH INC. | $5K | — | $5K | 0.04% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS SVCS LLC | 1920 MAIIN STREET SUITE 600 IRVINE, CA 92614 | AETNA HEALTH INC. | -$9K | — | -$9K | -0.07% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS SVCS LLC | 1920 MAIN STREET SUITE 600 IRVINE, CA 92614 | AETNA LIFE INSURANCE CO. | $6K | — | $6K | 0.17% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SVCS USA INC | 600 HIGHWAY 169 SOUTH SUITE 1200 ST. LOUIS PARK, MN 55426 | AETNA LIFE INSURANCE CO. | $5K | — | $5K | 0.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | 600 HIGHWAY 169 SOUTH SUITE 1200 ST. LOUIS PARK, MN 55426 | BLUECROSS BLUESHIELD OF ILLINOIS | $3K | — | $3K | 0.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 600 HIGHWAY 169 SOUTH SUITE 1200 ST. LOUIS PARK, MN 55426 | EYEMED VISION CARE ON BEHALF OF COMBINED INS CO OF AMERICA | $3K | — | $3K | 2.06% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 21250 HAWTHORNE BLVD 6TH FLOOR TORRANCE, CA 90503 | EYEMED VISION CARE ON BEHALF OF COMBINED INS CO OF AMERICA | $62 | — | $62 | 0.05% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 21250 HAWTHORNE BLVD 6TH FLOOR TORRANCE, CA 90503 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $7K | $851 | $8K | 6.39% |
| AON CONSULTING INC3 Filed as: CUSTOM BENEFIT PROGRAMS AON COMPANY | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $2K | $7K | 5.81% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA INC | 16220 N SCOTTSDALE ROAD STE 600 SCOTTSDALE, AZ 85254 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $88 | $1K | 0.87% |
| SULLIVANCURTISMONROE INS SVCS LLC3 Filed as: SULLIVANCURTISMONROE INS. SVCS, LLC | 1920 MAIN ST STE 600 IRVINE, CA 92614 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $980 | — | $980 | 0.78% |
| SULLIVANCURTISMONROE INS SVCS LLC3 Filed as: SULLIVANCURTISMONROE INS. SVCS, LLC | 1920 MAIN ST STE 600 IRVINE, CA 92614 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $726 | — | $726 | 0.58% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 21250 HAWTHORNE BLVD 6TH FLOOR TORRANCE, CA 90503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $347 | $4K | 77.69% |
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 | 2,812 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 10 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,832 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 4 carriers) | AETNA HEALTH INC. | 2,776 | $18.7M |
| Dental | AETNA LIFE INSURANCE CO. | 2,776 | $3.3M |
| Vision | EYEMED VISION CARE ON BEHALF OF COMBINED INS CO OF AMERICA | 4,591 | $127K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,879 | $1.2M |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,879 | $1.2M |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,879 | $1.2M |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,879 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,591 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.