| 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 LIBE NEW YORK, NY 10281 | ANTHEM HEALTH PLANS, INC | $221K | — | $221K | 1.38% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | ONE WORLD FINANCIAL CENTER 200 LIBE NEW YORK, NY 10281 | ANTHEM HEALTH PLANS, INC | $221K | — | $221K | 1.38% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEST INC | ONE WORLD FINANCIAL CENTER 200 LIBE NEW YORK, NY 10281 | BLUE CROSS OF CALIFORNIA | $24K | — | $24K | 1.33% |
| EMPYREAN INSURANCE SERVICES, INC.3 Filed as: EMPYREAN BENEFIT SOLUTIONS INC | 3010 BRIARPARK DR STE 8000 HOUSTON, TX 770423706 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $22K | $22K | 6.44% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORT | PO BOX 4557 NEW YORK, NY 10249 | LIFE INSURANCE COMPANY OF NORTH AMERICA | -$53K | — | -$53K | -15.16% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTH | PO BOX 4557 NEW YORK, NY 10249 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $58K | — | $58K | 20.00% |
| EMPYREAN INSURANCE SERVICES, INC.3 Filed as: EMPYREAN BENEFIT SOLUTIONS INC | 3010 BRIARPARK DR STE 8000 HOUSTON, TX 770423706 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $15K | $15K | 5.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORT | PO BOX 4557 NEW YORK, NY 14204 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $35K | — | $35K | 15.00% |
| EMPYREAN INSURANCE SERVICES, INC.3 Filed as: EMPYREAN BENEFIT SOLUTIONS INC | 3010 BRIARPARK DR STE 8000 HOUSTON, TX 770423706 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $12K | $12K | 5.00% |
| EMPYREAN BENEFITS3 Filed as: EMPYREAN BENEFIT SOLUTION INC | 3010 BRIARPARK DR STE 8000 HOUSTON, TX 770423706 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $4K | $4K | 5.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORT | PO BOX 4557 NEW YORK, NY 10249 | LIFE INSURANCE COMPANY OF NORTH AMERICA | -$3K | — | -$3K | -3.85% |
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 | 3,681 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 3,681 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM HEALTH PLANS, INC | 5,479 | $17.8M |
| Dental | ANTHEM HEALTH PLANS, INC | 5,479 | $16.0M |
| Vision(2 contracts, 2 carriers) | ANTHEM HEALTH PLANS, INC | 5,479 | $17.8M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 8,216 | $349K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 716 | $291K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 125 | $236K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 8,101 | $71K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 8,216 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.