| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | ONE WORLD FINANCIAL CENTER 200 LIBERTY STREET NEW YORK, NY 10281 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $244K | $10K | $254K | 15.60% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS CORROON CORP. OF NY INC. | ONE WORLD FINANCIAL CENTER 200 LIBERTY ST, 6TH FL, STE 6 NEW YORK, NY 10281 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $23K | — | $23K | 4.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | C/O WILLIS SAN FRNCSCO LCKBX 100485 BANC ONE DEPT 100485 PASADENA, CA 91189 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $13K | $13K | 2.30% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $571 | $571 | 0.10% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $1 | $1 | 0.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | 100 BANK STREET, SUITE 500 BURLINGTON, VT 05401 | KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC | $12K | $2K | $14K | 5.30% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | ONE WORLD FINANCIAL CENTER 200 LIBERTY ST NEW YORK, NY 10281 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | — | $10K | 15.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | ONE WORLD FINANCIAL CENTER 200 LIBERTY ST, FL. 6 NEW YORK, NY 10281 | UNITEDHEALTHCARE INSURANCE COMPANY | $7K | — | $7K | 10.87% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK, INC. | ONE WORLD FINANCIAL CENTER 200 LIBERTY STREET, 7TH FLOOR NEW YORK, NY 10281 | AXIS INSURANCE COMPANY | $2K | — | $2K | 25.00% |
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 | 706 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 45 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 751 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,110 | $1.9M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,110 | $1.6M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 410 | $62K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 706 | $580K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,110 | $1.9M |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 706 | $655K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,110 | — |
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.