| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWER WATSON DELAWARE INC | LOCKBOX#741909, PO BOX 741909 ATLANTA, GA 303741909 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $101K | $101K | 1.44% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON PENNSYLVANIA, INC. | LOCKBOX# 9102, PO BOX 8500 PHILADELPHIA, PA 191789102 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $17K | $17K | 0.24% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | 200 E RANDOLPH ST CHICAGO, IL 60601 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $6K | — | $6K | 0.39% |
| AON CONSULTING INC3 Filed as: AON RISK SOLUTIONS OF PR, INC. | PO BOX 191229 SAN JUAN, PR 009191229 | MEDICAL CARD SYSTEM LIFE INSURANCE, INC. | $25K | — | $25K | 5.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | COMMISSIONS LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $75K | $75K | 50.19% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA INC. | 12421 MEREDITH DR URBANDALE, IA 50322 | FEDERAL INSURANCE COMPANY | $15K | — | $15K | 15.00% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES OF PUERTO RICO | 304 AVDA, PONCE DE LEON HATO REY, PR 00918 | DELTA DENTAL OF PUERTO RICO, INC. | $5K | — | $5K | 7.00% |
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 | 20,302 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 367 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 149 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 20,818 | 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 | 107 | $2.1M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 107 | $1.6M |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 13,038 | $4.9M |
| Life insurance(4 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 22,811 | $8.3M |
| Long-term disability(2 contracts, 2 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 20,274 | $7.0M |
| Prescription drug | MEDICAL CARD SYSTEM LIFE INSURANCE, INC. | 105 | $503K |
| Other(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 17,525 | $2.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 22,811 | — |
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.