| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES | 5 CONCOURSE PARKWAY NE 18TH FL ATLANTA, GA 30328 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $7K | $7K | 3.21% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES | 5 CONCOURSE PARKWAY NE 18TH FL ATLANTA, GA 30328 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $4K | $4K | 3.25% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF GA | PO BOX 905260 CHARLOTTE, NC 282905260 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | $926 | $12K | 13.97% |
| WINGATE INSURANCE GROUP, INC.3 Filed as: WINGATE INSURANCE GROUP | 155 PROFESSIONAL DRIVE PONTE VEDRA BEACH, FL 32082 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $229 | $2K | 2.54% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES | 5 CONCOURSE PARKWAY NE 18TH FL ATLANTA, GA 30328 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $2K | $2K | 2.79% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES | 5 CONCOURSE PARKWAY NE 18TH FL ATLANTA, GA 30328 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $776 | $776 | 3.20% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH INSURANCE COMPANY EIN 59-1031071 PROVIDES CLAIM ADMIN | Direct payment from the plan; Float revenue; Contract Administrator; Non-monetary compensation; Claims processing; Named fiduciary; Participant communication; Other services Service code 12 | — | $246.9M |
| WWW.CIGNAACCESS.COM | Other services; Direct payment from the plan; Contract Administrator; Participant communication; Float revenue; Named fiduciary; Non-monetary compensation; Claims processing Service code 12 | — | $246.9M |
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 | 458 | 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) | 458 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ZURICH NORTH AMERICAN INSURANCE COMPANY | 420 | $641K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 458 | $230K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 458 | $58K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 458 | $122K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 458 | $86K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 458 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.