| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS | PO BOX 905260 CHARLOTTE, NC 28290 | KAISER FOUNDATION HEALTH PLAN INC | $15K | — | $15K | 4.17% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS | 5 CONCOURSE PARKWAY NE 18TH FLOOR ATLANTA, GA 30328 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $22K | $1K | $23K | 15.96% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES | 5 CONCOURSE PARKWAY NE 18TH FLOOR ATLANTA, GA 30328 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $21K | $1K | $22K | 17.39% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES | 5 CONCOURSE PARKWAY NE 18TH FLOOR ATLANTA, GA 30328 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $13K | $668 | $14K | 17.18% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF GEORGIA INC | 806 TYVOLA RD SUITE 108 CHARLOTTE, NC 282173538 | VISION SERVICE PLAN | $2K | — | $2K | 3.22% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF GEORGIA INC | PO BOX 905260 CHARLOTTE, NC 28290 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | — | $7K | 18.29% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF ATLANTA | 7000 CENTRAL PKWY NE SUITE 700 ATLANTA, GA 303686367 | METROPOLITAN LIFE INSURANCE COMPANY | $699 | — | $699 | 1.96% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS | 5 CONCOURSE PARKWAY NE 18TH FLOOR ATLANTA, GA 30328 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $277 | $5K | 17.29% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF GEORGIA | PO BOX 9052560 CHARLOTTE, NC 28290 | SUPERIOR DENTAL CARE, INC. | $167 | — | $167 | 7.75% |
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 | 421 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 435 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 1,076 | $5.5M |
| Dental(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 1,076 | $5.2M |
| Vision | VISION SERVICE PLAN | 367 | $65K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 425 | $146K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 425 | $127K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 425 | $81K |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 1,076 | $5.2M |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 425 | $67K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,076 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.