| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | 200 LIBERTY STREET, 6TH FLOOR NEW YORK, NY 10281 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $42K | — | $42K | 1.41% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA | 4250 EXECUTIVE SQUARE, STE 250 LA JOLLA, CA 92037 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | — | $7K | $7K | 0.23% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | 200 LIBERTY STREET NEW YORK, NY 10281 | EMBLEMHEALTH | $37K | — | $37K | 4.34% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | 200 LIBERTY ST, FL. 3 1 WORLD FINANCIAL CENTER NEW YORK, NY 102810001 | METROPOLITAN LIFE INSURANCE COMPANY | $11K | $13K | $24K | 3.24% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | 200 LIBERTY STREET NEW YORK, NY 10281 | EMBLEMHEALTH | $7K | — | $7K | 4.68% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | 200 LIBERTY ST, FL. 6 1 WORLD FINANCIAL CENTER NEW YORK, NY 102810001 | METROPOLITAN LIFE INSURANCE COMPANY | $424 | $539 | $963 | 3.04% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | 1 WORLD FINANCIAL CTR 200 LIBERTY STREET STREET, FL. 6 NEW YORK, NY 102810001 | METROPOLITAN LIFE INSURANCE COMPANY | $215 | $289 | $504 | 3.11% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | 200 LIBERTY STREET NEW YORK, NY 10281 | EMBLEMHEALTH | $816 | — | $816 | 8.06% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | 200 LIBERTY STREET NEW YORK, NY 10281 | EMBLEMHEALTH | $799 | — | $799 | 8.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | 200 LIBERTY STREET NEW YORK, NY 10281 | EMBLEMHEALTH | $155 | — | $155 | 8.00% |
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 | 669 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 469 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,142 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 617 | $3.9M |
| Dental(4 contracts, 2 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 617 | $3.0M |
| Life insurance(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 1,471 | $753K |
| Short-term disability(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 1,471 | $768K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 1,471 | $737K |
| Other(7 contracts, 3 carriers) | EMBLEMHEALTH | 1,471 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,471 | — |
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.