| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK | 1 WORLD FINANCIAL CTR 200 LIBERTY STREET. 6TH FL NEW YORK, NY 10281 | AETNA LIFE INSURANCE COMPANY | $4K | $7K | $12K | 1.27% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK, INC | ONE WORLD FINANCIAL, INC 200 LIBERTY ST. 6TH FL NEW YORK, NY 10281 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $592 | $4K | 11.52% |
| 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 | $2K | $333 | $3K | 11.35% |
| 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 | $2K | $233 | $2K | 11.20% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WILLIS OF NEW YORK | Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | 1 WORLD FINANCIAL CTR 200 LIBERTY STREET. 6TH FL NEW YORK, NY 10281 | $36K |
| WILLIS OF MASSACHUSETTS, INC EIN 04-2392279 | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $101 |
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 | 111 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 239 | $922K |
| Dental | AETNA LIFE INSURANCE COMPANY | 239 | $922K |
| Vision | AETNA LIFE INSURANCE COMPANY | 239 | $922K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 65 | $61K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 13 | $16K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 65 | $39K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 65 | $61K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 239 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.