| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | P.O. BOX 4557 NEW YORK, NY 10249 | AETNA LIFE INSURANCE COMPANY | — | $8K | $8K | 0.35% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $919 | $6K | 6.45% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 5.42% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | ONE WORLD FINANCIAL CENTER 200 LIBERTY ST, 6TH FL. NEW YORK, NY 10281 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $495 | $4K | 5.21% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $398 | $2K | 6.64% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 5.20% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | ONE WORLD FINANCIAL CTR 200 LIBERTY ST, 6TH FL. NEW YORK, NY 10281 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $178 | $2K | 4.47% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $409 | $2K | 7.53% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 5.83% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | ONE WORLD FINANCIAL CTR 200 LIBERTY ST, 6TH FL. NEW YORK, NY 10281 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $151 | $2K | 4.80% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | WILLIAMETTE DENTAL INSURANCE CO | $2K | — | $2K | 5.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | ONE WORLD FINANCIAL CENTER 200 LIBERTY ST, 6TH FL. NEW YORK, NY 10281 | UNUM INSURANCE COMPANY | $767 | $64 | $831 | 7.09% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM INSURANCE COMPANY | $527 | — | $527 | 4.50% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | P.O. BOX 632886 CINCINNATI, OH 45263 | UNUM INSURANCE COMPANY | $131 | $18 | $149 | 1.27% |
| GIS BENEFITS INC3 Filed as: GIS NATIONAL | 9500 KROGER AVE, STE 200 ST PETERSBURG, FL 33702 | METLIFE LEGAL PLANS | $2K | — | $2K | 27.37% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON, INC. | CHURCH STREET NEW YORK, NY 10249 | METLIFE LEGAL PLANS | $506 | — | $506 | 8.38% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN BEN. ADMNSTRTRS, INC. | P.O. BOX 9201 BLDG I, SUITE 100 AUSTIN, TX 78766 | METLIFE LEGAL PLANS | — | $453 | $453 | 7.50% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 WEST 47TH STREET, STE. 1100 KANSAS CITY, MO 64112 | METLIFE LEGAL PLANS | $401 | — | $401 | 6.64% |
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 | 245 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 248 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 372 | $2.2M |
| Dental(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 372 | $2.2M |
| Vision | AETNA LIFE INSURANCE COMPANY | 372 | $2.2M |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 245 | $122K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 68 | $33K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 245 | $86K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 372 | $2.2M |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 245 | $139K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 372 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.