| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 400 N EXECUTIVE DRIVE SUITE 300 BROOKFIELD, WI 53005 | QBE INSURANCE | — | $25K | $25K | 7.14% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | STANDARD INSURANCE COMPANY | $12K | — | $12K | 4.22% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON WEST INC | PO BOX 101162 PASADENA, CA 91189 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 0.51% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | STANDARD INSURANCE COMPANY | $7K | — | $7K | 3.86% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON WEST INC | PO BOX 101162 PASADENA, CA 91189 | STANDARD INSURANCE COMPANY | $714 | — | $714 | 0.42% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | 200 LIBERTY STREET 7TH FLOOR NEW YORK, NY 102811003 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $6K | — | $6K | 25.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | — | $333K |
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 CLAIM ADMINISTRATION | Float revenue; Other services; Claims processing; Non-monetary compensation; Direct payment from the plan; Participant communication; Named fiduciary; Contract Administrator Service code 12 | — | $32K |
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 | 695 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 695 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 459 | $91K |
| Life insurance(3 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 720 | $349K |
| Long-term disability | STANDARD INSURANCE COMPANY | 575 | $170K |
| Stop-loss / reinsurancereinsurance | QBE INSURANCE | 525 | $357K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 720 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.