| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF FLORIDA INC | 1450 BRICKELL AVENUE STE 1600 MIAMI, FL 33131 | SUN LIFE ASSURANCE COMPANY OF CANADA | $17K | — | $17K | 7.45% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 1501 REEDSDALE ST STE 403 PITTSBURGH, PA 15233 | SUN LIFE ASSURANCE COMPANY OF CANADA | $8K | — | $8K | 3.37% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CALI. | PO BOX 101162 PASADENA, CA 91189 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | — | $2K | 0.98% |
| UMR, INC.3 Filed as: UMR | 5151 PFEIFFER RD ML 400 CINCINNATI, OH 45242 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 0.66% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF FLORIDA | 1450 BRICKELL AVENUE STE 1600 MIAMI, FL 33131 | AETNA LIFE INSURANCE CO. | $9K | — | $9K | 8.26% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 1301 DOVE STREET STE 200 NEWPORT BEACH, CA 92660 | AETNA LIFE INSURANCE CO. | $2K | — | $2K | 1.71% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF FLORIDA INC | 29848 NETWORK PL CHICAGO, IL 606731298 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $250 | $2K | 7.48% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES, INC | 1451 W CYPRESS CRK RD FT LAUDERDALE, FL 33309 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 3.35% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF FLORIDA - TAMPA FL | 29848 NETWORK PLACE CHICAGO, IL 28290 | EYE MED | $1K | — | $1K | 5.74% |
| ALLIANT INSURANCE SERVICES, INC. Filed as: ALLIANT INSURANCE SERVICES | 2202 NORTH WEST SHORE BOULEVARD TAMPA, FL 33607 | EYE MED | $703 | — | $703 | 3.35% |
| WILLIS TOWERS WATSON US LLC Filed as: WILLIS OF FLORIDA - TAMPA FL | PO BOX 904037 CHARLOTTE, NC 28290 | EYE MED | $176 | — | $176 | 0.84% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC EIN 33-0441200 PHARMACY BENEFIT MGMT | Other fees; Claims processing; Float revenue; Direct payment from the plan Service code 12 | — | $375K |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | PO BOX 1087 WAUSAU, WI 54402 | $117K |
| AETNA LIFE INSURANCE EIN 06-6033492 CLAIMS PROCESSING | Claims processing Service code 12 | 4300 CENTREWAY PLACE ARLINGTON, TX 76018 | $0 |
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 | 266 | 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) | 266 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYE MED | 247 | $21K |
| Life insurance(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 626 | $135K |
| Short-term disability | AETNA LIFE INSURANCE CO. | 626 | $105K |
| Long-term disability | AETNA LIFE INSURANCE CO. | 626 | $105K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 266 | $224K |
| Other | AETNA LIFE INSURANCE CO. | 626 | $105K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 626 | — |
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.