| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | STANDARD INSURANCE COMPANY | — | $1K | $1K | 1.48% |
| AMERICAN BEN. AND COMP. SYS. INC.3 Filed as: AMERICAN BEN AND COMP SYSTEMS | 101 PARK AVE FL 14 NEW YORK, NY 101782103 | STANDARD INSURANCE COMPANY | — | $1K | $1K | 1.20% |
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | STANDARD INSURANCE COMPANY | — | $1K | $1K | 1.50% |
| AMERICAN BEN. AND COMP. SYS. INC.3 Filed as: AMERICAN BEN AND COMP SYSTEMS | 101 PARK AVE FL 14 NEW YORK, NY 101782103 | STANDARD INSURANCE COMPANY | — | $856 | $856 | 1.22% |
| AMERICAN BEN. AND COMP. SYS. INC.3 Filed as: AMERICAN BEN & COMP SYSTEMS INC | 101 PARK AVE 14TH FLOOR NEW YORK, NY 10178 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $282 | — | $282 | 0.79% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $4 | $4 | 0.01% |
| AMERICAN BEN. AND COMP. SYS. INC.3 Filed as: AMERICAN BEN & COMP SYSTEMS INC | 101 PARK AVE 14TH FLOOR NEW YORK, NY 10178 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $220 | — | $220 | 1.48% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $3 | $3 | 0.02% |
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 | 93 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 160 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 253 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(4 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 332 | $214K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 207 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 332 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.