| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 29982 NETWORK PLACE CHICAGO, IL 60673 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $39K | $39K | 3.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TN-NASHVILLE | 26 CENTURY BLVD NASHVILLE, TN 37230 | DELTA DENTAL OF TENNESSEE | $10K | — | $10K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 75 BEATTLE PLACE STE 601 GREENVILLE, SC 29601 | HARTFORD LIFE AND ACCIDENT | $14K | — | $14K | 15.86% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | SERVICES WEST 801 S FIGUEROA ST., STE 800 LOS ANGELES, CA 90017 | HARTFORD LIFE AND ACCIDENT | — | $636 | $636 | 0.75% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 29982 NETWORK PL CHICAGO, IL 60673 | VISION SERVICE PLAN | $934 | — | $934 | 5.68% |
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 | 155 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 14 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 170 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 127 | $1.3M |
| Dental | DELTA DENTAL OF TENNESSEE | 315 | $98K |
| Vision | VISION SERVICE PLAN | 124 | $16K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 147 | $85K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 147 | $85K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 147 | $85K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 127 | $1.3M |
| Other | HARTFORD LIFE AND ACCIDENT | 147 | $85K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 315 | — |
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.