| 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 | SUN LIFE ASSURANCE COMPANY OF CANADA | $111K | — | $111K | 13.87% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 525 MARKET ST SUITE 3400 SAN FRANCISCO, CA 94105 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $45K | $45K | 5.55% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MARYLAND INC | PO BOX 13784 NEWARK, NJ 07188 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $38K | — | $38K | 15.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MARYLAND INC | 12505 PARK POTOMAC AVE STE 300 POTOMAC, MD 20854 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $6K | $6K | 2.20% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | PO BOX 13784 NEWARK, NJ 07188 | VISION SERVICE PLAN | $4K | — | $4K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE LOOMIS COMPANY EIN 23-2238132 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $163K |
| WILLIS OF MARYLAND, INC EIN 52-0559369 NONE | Contract Administrator; Direct payment from the plan; Insurance brokerage commissions and fees Service code 13 | — | $114K |
| CIGNA EIN 35-2029627 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $59K |
| HINES & ASSOCIATES EIN 36-3545085 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $19K |
| ZELIS CLAIMS INTEGRITY INC. EIN 86-1040704 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $13K |
| TELADOC INC. EIN 04-3705970 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $6K |
| CIGNA DENTAL EIN 35-2029627 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $6K |
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 | 371 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 18 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 389 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 261 | $38K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 370 | $254K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 370 | $254K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 370 | $254K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 327 | $803K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 370 | $254K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 370 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.