| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE | COMMISSIONS LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $9K | $9K | 1.33% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $5K | $5K | 1.06% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | PO BOX 741909 LOCKBOX 741909 ATLANTA, GA 303741909 | RELIASTAR LIFE INSURANCE COMPANY | $3K | $3K | $5K | 10.14% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $320 | $320 | 1.33% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LIBERTY LIFE ASSURANCE CO EIN 04-6076039 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $392K |
| TOWERS WATSON DELAWARE, INC. EIN 53-0181291 NONE | Actuarial; Consulting (pension); Direct payment from the plan Service code 11 | — | $78K |
| PRYAMIS GLOBAL ADVISORS TRUST CO NONE | Investment management fees paid directly by plan; Investment management Service code 28 | 26332 NETWORK PL CHICAGO, IL 66073 | $60K |
| RELIASTAR LIFE INSURANCE CO. EIN 41-0451140 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $49K |
| HORIZON BLUE CROSS BLUE SHIELD EIN 22-0999690 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $30K |
| MEDCO HEALTH SOLUTIONS EIN 22-3461740 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $28K |
| WEISERMAZARS LLP EIN 13-1459550 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $27K |
| WELLS FARGO EIN 94-1347393 NONE | Direct payment from the plan; Claims processing; Recordkeeping fees; Distribution (12b-1) fees; Investment management; Trustee (bank, trust company, or similar financial institution); Shareholder servicing fees; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue Service code 12 | — | $19K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 583 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 583 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 577 | $427K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 2,341 | $651K |
| Stop-loss / reinsurancereinsurance | RELIASTAR LIFE INSURANCE COMPANY | 82 | $54K |
| Other(2 contracts) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 577 | $451K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,341 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.