| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | — | $6K | $6K | 1.18% |
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 0.56% |
| WILLIS TOWERS WATSON US LLC3 | 800 N. GLEBE ROAD ARLINGTON, VA 22203 | DELTA DENTAL OF PENNSYLVANIA | $9K | — | $9K | 5.00% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX 28852, P.O. BOX 28852 NEW YORK, NY 10281 | 4 EVER LIFE INSURANCE COMPANY | $5K | — | $5K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 | 75 ARLINGTON STREET, FLOOR 10 BOSTON, MA 02116 | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $140 | $2K | 7.68% |
| WILLIS TOWERS WATSON US LLC3 | 800 N GLEBE RD, 10TH FLOOR ARLINGTON, VA 22203 | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | $88 | $17 | $105 | 8.40% |
| FIDELITY HEALTH INSURANCE SERVICES3 | 20 COMMERCE WAY STE 800, PNC BANK C/O FMR LLC LOCKBOX NUMBER 844303 WOBURN, MA 018018504 | METLIFE LEGAL PLANS | $51 | $75 | $126 | 24.51% |
| FIDELITY HEALTH INSURANCE SERVICES3 | 20 COMMERCE WAY STE 800, PNC BANK C/O FMR LLC LOCKBOX NUMBER 844303 WOBURN, MA 018018504 | METLIFE LEGAL PLANS | $51 | — | $51 | 9.92% |
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 | 248 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 252 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 138 | $3.1M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF PENNSYLVANIA | 418 | $233K |
| Vision(2 contracts, 2 carriers) | 4 EVER LIFE INSURANCE COMPANY | 166 | $68K |
| Life insurance | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | 245 | $546K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | 245 | $546K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | 245 | $546K |
| Other(5 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY | 501 | $573K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 501 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.