| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | ONE WORLD FINANCIAL CTR 200 LIBERTY ST, 6TH FL. NEW YORK, NY 10281 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $4K | $4K | 1.25% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | ONE WORLD FINANCIAL CTR 200 LIBERTY ST, 6TH FL. NEW YORK, NY 10281 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $828 | $828 | 1.25% |
| EMPLOYEE FAMILY PROTECTION INC3 Filed as: EMPLOYEE FAMILY PROTECTION INC. | ATTN MICHAEL STEPNOWSKI PO BOX 1237 GLASTONBURY, CT 06033 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $15K | $3K | $18K | 38.34% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | ONE WORLD FINANCIAL CTR 200 LIBERTY ST, 6TH FL. NEW YORK, NY 10281 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $785 | $7K | 15.33% |
| SMITH BROTHERS INSURANCE LLC3 Filed as: SMITH BROTHER INS. INC. | 68 NATIONAL DR. GLASTONBURY, CT 06033 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $166 | — | $166 | 0.36% |
| ASSUREX3 | 175 S THIRD ,ST STE 800 COLUMBUS, OH 43215 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | -$2 | -$2 | -0.00% |
| EMPLOYEE FAMILY PROTECTION INC3 Filed as: EMPLOYEE FAMILY PROTECTION INC. | ATTN MICHAEL STEPNOWSKI PO BOX 1237 GLASTONBURY, CT 06033 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $611 | $8K | 23.23% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | ONE WORLD FINANCIAL CTR 200 LIBERTY STREET, 6TH FL. NEW YORK, NY 10281 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $57 | $3K | 8.24% |
| SMITH BROTHERS INSURANCE LLC3 Filed as: SMITH BROTHERS INS INC. | 68 NATIONAL DR. GLASTONBURY, CT 06033 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $419 | $1 | $420 | 1.17% |
| EMPLOYEE FAMILY PROTECTION INC3 Filed as: EMPLOYEE FAMILY PROTECTION INC. | ATTN MICHAEL STEPNOWSKI PO BOX 1237 GLASTONBURY, CT 06033 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $1K | $7K | 19.22% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | ONE WORLD FINANCIAL CENTER 200 LIBERTY ST, 6TH FL. NEW YORK, NY 10281 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $419 | $3K | 7.55% |
| SMITH BROTHERS INSURANCE LLC3 Filed as: SMITH BROTHERS INS. INC. | 68 NATIONAL DR. GLASTONBURY, CT 06033 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.03% |
| EMPLOYEE FAMILY PROTECTION INC3 Filed as: EMPLOYEE FAMILY PROTECTION INC. | ATTN MICHAEL STEPNOWSKI PO BOX 1237 GLASTONBURY, CT 06033 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $160 | $3K | 10.34% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | ONE WORLD FINANCIAL CTR 200 LIBERTY ST, 6TH FL. NEW YORK, NY 10281 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $15 | $1K | 4.28% |
| SMITH BROTHERS INSURANCE LLC3 Filed as: SMITH BROTHERS INS. INC. | 68 NATIONAL DR. GLASTONBURY, CT 06033 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5 | — | $5 | 0.01% |
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 | 673 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 345 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,019 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF NJ, INC. | 160 | $132K |
| Life insurance(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 894 | $480K |
| Short-term disability(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 894 | $414K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 894 | $333K |
| Other(6 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 894 | $550K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 894 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.