| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | PO BOX 31817 CHARLOTTE, NC 28231 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $73K | — | $73K | 11.59% |
| FORESTER BENEFITS MANAGEMENT LLC3 | 1909 PINNACLE POINT WAY KNOXVILLE, TN 37922 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $42K | $3K | $45K | 7.16% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SERV | 500 N. AKARD STREET SUITE 4300 DALLAS, TX 75201 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $10K | $10K | 1.59% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 1.75% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | PO BOX 90554 CHARLOTTE, NC 28202 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $960 | — | $960 | 0.75% |
| FORESTER BENEFITS MANAGEMENT LLC3 Filed as: FORESTER BENEFITS MANAGEMENT, LLC | 1909 PINNACLE POINTE WAY KNOXVILLE, TN 37922 | BANKERS FIDELITY LIFE INSURANCE COMPANY | $15K | — | $15K | 27.53% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 1 BANK AMERICA CENTER 150 NORTH COLLEGE STREET CHARLOTTE, NC 28202 | BANKERS FIDELITY LIFE INSURANCE COMPANY | $4K | — | $4K | 6.42% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 29727 NETWORK PLACE CHICAGO, IL 60673 | EYEMED VISION CARE | $2K | — | $2K | 4.77% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | EMPLOYEE BENEFITS PRACTICE 200 LIBERTY STREET NEW YORK, NY 10281 | HARTFORD LIFE AND ACCIDENT | — | — | $0 | — |
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 | 498 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 498 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE | 663 | $48K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 527 | $631K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 527 | $631K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 527 | $631K |
| Other(4 contracts, 4 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 527 | $815K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 663 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.