| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC7 Filed as: TOWERS WATSON DELAWARE INC. | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $40K | $40K | 3.88% |
| WILLIS TOWERS WATSON US LLC7 Filed as: TOWERS WATSON DELAWARE INC. | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE OF NORTH AMERICA | — | $32K | $32K | 4.93% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 10087 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $12K | — | $12K | 5.00% |
| WILLIS TOWERS WATSON US LLC7 Filed as: TOWERS WATSON DELAWARE INC. | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $7K | $7K | 4.77% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 10087 | ACE AMERICAN INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| WILLIS TOWERS WATSON US LLC7 Filed as: TOWERS WATSON DELWARE INC. | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 10087 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | — | $617 | $617 | 3.00% |
| WILLIS TOWERS WATSON US LLC7 Filed as: TOWERS WATSON DELAWARE INC. | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $880 | $880 | 4.89% |
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 | 2,859 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 18 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,880 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 19 | $231K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,995 | $1.2M |
| Short-term disability(2 contracts, 2 carriers) | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | 670 | $39K |
| Long-term disability | LIFE INSURANCE OF NORTH AMERICA | 2,832 | $654K |
| Other(6 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,995 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,832 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.