| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF PENNSYLVANIA, INC. | 100 MATSONFORD RD BLDG 5 RADNOR, PA 190874559 | SUN LIFE ASSURANCE COMPANY OF CANADA | $194K | — | $194K | 24.82% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF PENNSYLVANIA, INC. | PO BOX 32090 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $11K | $3K | $14K | 6.59% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF PENNSYLVANIA, INC. | PO BOX 32090 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $22K | $3K | $25K | 11.57% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF PENNSYLVANIA, INC. | PO BOX 32090 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $31K | $3K | $34K | 16.66% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF PENNSYLVANIA, INC. | 100 MATSONFORD RD BLDG 5 WAYNE, PA 190874559 | RELIASTAR LIFE INSURANCE COMPANY | $23K | $0 | $23K | 19.52% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF PENNSYLVANIA, INC. | PO BOX 32090 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $511 | $5K | 16.62% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF PENNSYLVANIA, INC. | PO BOX 32090 NEW YORK, NY 10087 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $164K | — | $164K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 SELF THROUGH ASA | Float revenue; Named fiduciary; Participant communication; Claims processing; Contract Administrator; Direct payment from the plan; Other services; Non-monetary compensation Service code 12 | PO BOX 20643 LEHIGH VALLEY, PA 180020643 | $684K |
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 | 1,599 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,599 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,599 | $0 |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 647 | $205K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,136 | $219K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,136 | $217K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,599 | $781K |
| Other(2 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 1,277 | $150K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,599 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.