| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | HARTFORD LIFE AND ACCIDENT | $30K | — | $30K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 10087 | KAISER FOUNDATION HEALTH PLAN, INC. | $3K | — | $3K | 1.40% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $7K | — | $7K | 10.84% |
| EMPYREAN INSURANCE SERVICES, INC.5 Filed as: EMPYREAN INSURANCE SERVICES | PO BOX 2569 BELLAIRE, TX 77402 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | — | $3K | $3K | 4.91% |
| LIAZON BENEFITS INC3 Filed as: LIAZON CORPORATION - EXCHANGE | 199 SCOTT ST, 8TH FLOOR BUFFALO, NY 14204 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $567 | — | $567 | 0.86% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 10087 | KAISER FOUNDATION HEALTH PLAN, INC. | $955 | — | $955 | 1.53% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 10087 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | $2K | $12K | 24.80% |
| EMPYREAN INSURANCE SERVICES, INC.5 Filed as: EMPYREAN BENEFIT SOLUTIONS INC | 3010 BRIARPARK DR # 8000 HOUSTON, TX 77042 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 3.56% |
| EMPYREAN INSURANCE SERVICES, INC.5 Filed as: EMPYREAN INSURANCE SERVICES INC | PO BOX 2569 BELLAIRE, TX 77402 | METROPOLITAN LIFE INSURANCE COMPANY | — | -$124 | -$124 | -0.25% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 10087 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $34 | $2K | 5.20% |
| EMPYREAN INSURANCE SERVICES, INC.5 Filed as: EMPYREAN BENEFIT SOLUTIONS INC | 3010 BRIARPARK DR # 8000 HOUSTON, TX 77042 | METROPOLITAN LIFE INSURANCE COMPANY | — | $436 | $436 | 1.24% |
| EMPYREAN INSURANCE SERVICES, INC.3 Filed as: EMPYREAN INSURANCE SERVICES INC | PO BOX 2569 BELLAIRE, TX 77402 | METROPOLITAN LIFE INSURANCE COMPANY | — | $338 | $338 | 0.96% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 10087 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $1K | $9K | 35.94% |
| EMPYREAN INSURANCE SERVICES, INC.5 Filed as: EMPYREAN BENEFIT SOLUTIONS INC | 3010 BRIARPARK DR # 8000 HOUSTON, TX 77042 | METROPOLITAN LIFE INSURANCE COMPANY | — | $1K | $1K | 4.14% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 8400 NORMANDALE LAKE BLVD SUITE 1700 BLOOMINGTON, MN 55437 | METROPOLITAN GENERAL INSURANCE COMPANY | $515 | — | $515 | 5.91% |
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 | 426 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 434 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN, INC. | 38 | $300K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 816 | $66K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 502 | $298K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 502 | $298K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN, INC. | 38 | $300K |
| Other(6 contracts, 4 carriers) | HARTFORD LIFE AND ACCIDENT | 650 | $426K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 816 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.