| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | 1 WORLD FINANCIAL CTR 200 LIBERTY STREET NEW YORK, NY 10281 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $2K | — | $2K | 0.23% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SVCS WEST | 1 WORLD FINANCIAL CTR 200 LIBERTY STREET NEW YORK, NY 10281 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $5 | $5 | 0.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | ONE WORLD FINANCIAL CENTER 200 LIBERTY ST, 6TH FL, STE 6 NEW YORK, NY 10281 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $24K | — | $24K | 3.63% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS W INC | P.O. BOX 101162 PASADENA, CA 91189 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $11K | $11K | 1.58% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $143 | $143 | 0.02% |
| 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 | $5K | $320 | $5K | 4.46% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | P.O. BOX 4557 NEW YORK, NY 10249 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $17K | — | $17K | 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 | $8K | — | $8K | 9.95% |
| 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 | 727 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 741 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC | 15 | $116K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,197 | $943K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 804 | $80K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 727 | $667K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC | 15 | $116K |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 727 | $785K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,197 | — |
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.