| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST | 2101 6TH AVE N BIRMINGHAM, AL 35203 | SYMETRA | $27K | $7K | $34K | 20.00% |
| AMWINS5 Filed as: AMWINS GROUP BENEFITS LLC | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | TRANSAMERICA INSURANCE CO | $7K | — | $7K | 13.13% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | TRANSAMERICA INSURANCE CO | $1K | — | $1K | 2.35% |
| WEB TPA5 | 8500 FREEPORT PKWY SOUTH IRVING, TX 75063 | TRANSAMERICA INSURANCE CO | $1K | — | $1K | 2.16% |
| AMWINS5 Filed as: AMWINS GROUP BENEFITS LLC | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | EXPRESS SCRIPTS INC | $1K | — | $1K | 20.70% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | EXPRESS SCRIPTS INC | $96 | — | $96 | 1.48% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UFCW HEALTH & WELFARE FUND INSURANCE SERVICE | Insurance agents and brokers Service code 22 | 66 GRAND AVE ENGLEWOOD, NJ 07631 | $2.0M |
| CIGNA HEALTH & LIFE INSURANCE CO CLAIMS ADMINISTRATOR | Contract Administrator; Non-monetary compensation; Participant communication; Named fiduciary; Other services; Float revenue; Direct payment from the plan; Claims processing Service code 12 | — | $29K |
| WILLIS TOWERS WATSON SOUTHEAST BROKER | Insurance agents and brokers Service code 22 | 2102 6TH AVE N BIRMINGHAM, AL 35203 | $27K |
| AMWINS GROUP BENEFITS LLC AGENT | Insurance agents and brokers Service code 22 | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | $8K |
| MERCER HEALTH & BENEFITS LLC BROKER | Insurance agents and brokers Service code 22 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | $8K |
| CIGNA | Other services; Named fiduciary; Participant communication; Contract Administrator; Non-monetary compensation; Claims processing; Float revenue; Direct payment from the plan Service code 12 | — | $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 | 175 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 188 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | TRANSAMERICA INSURANCE CO | 13 | $53K |
| Life insurance | SYMETRA | 214 | $171K |
| Short-term disability | SYMETRA | 214 | $171K |
| Prescription drug | EXPRESS SCRIPTS INC | 8 | $6K |
| Other | SYMETRA | 214 | $171K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 214 | — |
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.