| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK, INC. | 200 LIBERTY STREET NEW YORK, NY 10281 | DEAN HEALTH PLAN INC. | $21K | — | $21K | 1.41% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK, INC. | 200 LIBERTY STREET NEW YORK, NY 10281 | OXFORD HEALTH INSURANCE, INC. | $22K | $936 | $23K | 4.50% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK, INC. | 200 LIBERTY STREET NEW YORK, NY 10281 | DELTA DENTAL OF WISCONSIN | $10K | — | $10K | 10.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK, INC. | 1 WORLD FINANCIAL CENTER 200 LIBERTY STREET 6TH FLOOR NEW YORK, NY 10281 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $8K | $820 | $9K | 11.07% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK, INC. | 1 WORLD FINANCIAL CENTER 200 LIBERTY STREET 6TH FLOOR NEW YORK, NY 10281 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $174 | $3K | 10.54% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK, INC. | 1 WORLD FINANCIAL CENTER 200 LIBERTY STREET 6TH FLOOR NEW YORK, NY 10281 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $299 | $3K | 11.07% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK, INC. | 200 LIBERTY STREET NEW YORK, NY 10281 | DELTA DENTAL OF WISCONSIN | $2K | — | $2K | 10.25% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK, INC. | 1 WORLD FINANCIAL CENTER 200 LIBERTY STREET, 6TH FLOOR NEW YORK, NY 10281 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | — | $1K | 9.92% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK, INC. | 1 WORLD FINANCIAL CENTER 200 LIBERTY STREET 6TH FLOOR NEW YORK, NY 10281 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $578 | $83 | $661 | 11.44% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK, INC. | 1 WORLD FINANCIAL CENTER 200 LIBERTY STREET 6TH FLOOR NEW YORK, NY 10281 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $137 | $11 | $148 | 16.21% |
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 | 225 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 228 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | DEAN HEALTH PLAN INC. | 282 | $2.0M |
| Dental(2 contracts) | DELTA DENTAL OF WISCONSIN | 72 | $122K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 291 | $15K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 211 | $38K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 211 | $77K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 211 | $28K |
| Other(3 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 211 | $61K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 291 | — |
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.