| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE IN | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | CIGNA GROUP INSURANCE | — | $8K | $8K | 0.32% |
| WISTED, DANIEL, J3 Filed as: WISTED, DANIEL J | PRESTON RDG IV STE 325 3440 PRESTON RIDGE RD ALPHARETTA, GA 30005 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | — | $5K | 26.13% |
| DANIEL J WISTED3 Filed as: DANIEL J. WISTED | 3440 PRESTON RIDGE RD ALPHARETTA, GA 30005 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY, TENNESSEE | $2K | — | $2K | 17.88% |
| NEWPORT GROUP3 Filed as: NEWPORT GROUP INC | 300 INTERNATIONAL PKWY STE 270 HEATHROW, FL 32746 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY, TENNESSEE | $60 | — | $60 | 0.57% |
| DONALD QUINT3 | 1924 S UTICA STE 710 TULSA, OK 74104 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY, TENNESSEE | $20 | — | $20 | 0.19% |
| FRANK FISHER3 | 900 REUNION CENTER 9 E 4TH ST TULSA, OK 74103 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY, TENNESSEE | $15 | — | $15 | 0.14% |
| DAVID LOWERY HOUSTON3 Filed as: DAVID HOUSTON | 6301 WATERFORD BLVD STE 410 OKLAHOMA CITY, OK 73118 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY, TENNESSEE | $12 | — | $12 | 0.11% |
| MICHAEL CORRY3 | 701 MARKET ST STE 1000 ST. LOUIS, MO 63301 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY, TENNESSEE | $6 | — | $6 | 0.06% |
| WISTED, DANIEL, J3 Filed as: WISTED, DANIEL J. | 3440 PRESTON RIDGE RD STE 325 ALPHARETTA, GA 30005 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 68.75% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE IN | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | CIGNA GROUP INSURANCE | — | $31 | $31 | 0.98% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE IN | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | CIGNA GROUP INSURANCE | — | $2 | $2 | — |
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 | 6,618 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 6,618 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Short-term disability(2 contracts) | CIGNA GROUP INSURANCE | 94 | $3K |
| Long-term disability(4 contracts, 3 carriers) | CIGNA GROUP INSURANCE | 6,618 | $2.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,618 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.