| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERSWATSON MIDWEST, INC. | 233 SOUTH WACKER DRIVE, SUITE 1800 CHICAGO, IL 60606 | HARTFORD LIFE AND ACCIDENT | $318K | — | $318K | 11.73% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SVCS | 801 SOUTH FIGUEROA STREET LOS ANGELES, CA 90017 | HARTFORD LIFE AND ACCIDENT | $0 | $46K | $46K | 1.71% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE, INC. | 26 CENTURY BOULEVARD C/O J P MORGAN CHASE NASHVILLE, TN 37214 | METROPOLITAN LIFE INSURANCE COMPANY | — | $23K | $23K | 0.87% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE, INC. | 29982 NETWORK PLACE CHICAGO, IL 60673 | METROPOLITAN LIFE INSURANCE COMPANY | $18K | $64 | $18K | 0.70% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERSWATSON MIDWEST, INC. | 233 SOUTH WACKER DRIVE, SUITE 1800 CHICAGO, IL 60606 | NATIONAL VISION ADMINISTRATORS, LLC | $45K | $0 | $45K | 10.00% |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 86 | $771K |
| Vision | NATIONAL VISION ADMINISTRATORS, LLC | 5,778 | $450K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 15,870 | $2.6M |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 86 | $771K |
| Other(4 contracts, 4 carriers) | HARTFORD LIFE AND ACCIDENT | 15,870 | $5.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 15,870 | — |
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.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.