| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | PO BOX 13784 NEWARK, NJ 07188 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $27K | $76K | $103K | 1.27% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 LOCKBOX 28852 NEW YORK, NY 10087 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $947 | $947 | 0.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 12505 PARK POTOMAC AVE STE 300 POTOMAC, MD 20854 | KAISER FOUNDATION HEALTH PLAN INC | $4K | — | $4K | 0.78% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 12505 PARK POTOMAC AVENUE SUITE 300 POTOMAC, MD 20854 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | $4K | — | $4K | 2.04% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | PO BOX 13784 NEWARK, NJ 07188 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 2.70% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 12505 PARK POTOMAC AVE STE 300 POTOMAC, MD 20854 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 1.63% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | PO BOX 13784 NEWARK, NJ 07188 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 3.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | PO BOX 13784 NEWARK, NJ 07188 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 3.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | PO BOX 13784 NEWARK, NJ 07188 | VISION SERVICE PLAN | $4K | — | $4K | 4.59% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 225 SCHILLING CIRCLE STE 150 HUNT VALLEY, MD 21031 | TRIPLE S SALUD, INC. | $4K | — | $4K | 4.95% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | PO BOX 13784 NEWARK, NJ 07188 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | — | $8K | 15.91% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | PO BOX 13784 NEWARK, NJ 07188 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 16.11% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | PO BOX 13784 NEWARK, NJ 07188 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 16.02% |
| WILLIS TOWERS WATSON US LLC0 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | PO BOX 13784 NEWARK, NJ 07188 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $473 | — | $473 | 3.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EVERNORTH BEHAVIORAL HEALTH, INC. EIN 41-1648670 ADMINISTRATOR | Contract Administrator; Direct payment from the plan; Claims processing; Participant communication Service code 12 | — | $13K |
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 | 939 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 36 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 978 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 5 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 681 | $9.2M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 681 | $8.2M |
| Vision | VISION SERVICE PLAN | 665 | $96K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 939 | $144K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 939 | $198K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 939 | $98K |
| Prescription drug(5 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 681 | $9.1M |
| Other(5 contracts, 2 carriers) | TRIPLE S SALUD, INC. | 939 | $213K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 939 | — |
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."
No prospect flags tripped on this filing.