| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | ONE WORLD FINANCIAL CENTER 200 LIBERTY STREET NEW YORK, NY 10281 | ANTHEM HEALTH PLANS, INC. | $273K | — | $273K | 1.31% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | ONE WORLD FINANCIAL CENTER 200 LIBERTY ST NEW YORK, NY 10281 | BLUE CROSS OF CALIFORNIA | $12K | — | $12K | 0.45% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | P.O. BOX 4557 NEW YORK, NY 10249 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $193K | $7K | $199K | 17.44% |
| LIAZON BENEFITS INC3 Filed as: LIAZON CORPORATION | 199 SCOTT ST, SUITE 800 BUFFALO, NY 14204 | LIFE INSURANCE COMPANY OF NORTH AMERICA | -$5K | $57K | $52K | 4.54% |
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 | 3,763 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 62 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 250 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,075 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM HEALTH PLANS, INC. | 4,413 | $23.5M |
| Dental | ANTHEM HEALTH PLANS, INC. | 4,413 | $20.9M |
| Vision | ANTHEM HEALTH PLANS, INC. | 4,413 | $20.9M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 3,763 | $1.1M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 3,763 | $1.1M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 3,763 | $1.1M |
| Prescription drug(2 contracts, 2 carriers) | ANTHEM HEALTH PLANS, INC. | 4,413 | $23.5M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 3,763 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,413 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.