| 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 | — | $799 | $799 | 1.24% |
| 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 | $2K | — | $2K | 3.41% |
| 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 | $1K | $23 | $2K | 3.21% |
| SMITH BROTHERS INSURANCE LLC3 Filed as: SMITH BROTHER INS. LLC | 68 NATIONAL DR. GLASTONBURY, CT 06033 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $185 | — | $185 | 0.40% |
| 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 | $1K | — | $1K | 3.81% |
| 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 | $556 | $2 | $558 | 1.69% |
| SMITH BROTHERS INSURANCE LLC3 Filed as: SMITH BROTHERS INS. LLC | 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 | $1K | — | $1K | 4.58% |
| 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 | $562 | $27 | $589 | 2.04% |
| SMITH BROTHERS INSURANCE LLC3 Filed as: SMITH BROTHERS INS. LLC | 68 NATIONAL DR. GLASTONBURY, CT 06033 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $329 | — | $329 | 1.14% |
| 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 | $1K | — | $1K | 5.59% |
| 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 | $570 | — | $570 | 2.38% |
| SMITH BROTHERS INSURANCE LLC3 Filed as: SMITH BROTHERS INS. LLC | 68 NATIONAL DR. GLASTONBURY, CT 06033 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4 | — | $4 | 0.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW JERSEY INC. | 150 JOHN F. KENNEDY PARKWAY SUITE 520 SHORT HILLS, NJ 07078 | ANTHEM HEALTH PLANS, INC. | $3K | — | $3K | 11.01% |
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 | 520 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 525 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | ANTHEM HEALTH PLANS, INC. | 150 | $23K |
| Life insurance(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 629 | $487K |
| Short-term disability(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 629 | $422K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 629 | $343K |
| Other(6 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 629 | $540K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 629 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.