| 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 | $10K | — | $10K | 0.54% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE IN | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | CIGNA GROUP INSURANCE | — | $18 | $18 | 0.02% |
| WISTED, DANIEL, J3 Filed as: WISTED, DANIEL J. | 3440 PRESTON RIDGE RD STE 325 ALPHARETTA, GA 30005 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $8K | — | $8K | 28.91% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE IN | COMMISSION LOCK BOX 28852 PO BOX 28852 NEW YORK, NY 10087 | CIGNA GROUP INSURANCE | $43 | — | $43 | 0.57% |
| 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 | $2K | — | $2K | 21.50% |
| DANIEL J WISTED3 Filed as: DANIEL J. WISTED | PRESTON RIDGE IV STE 325 3440 PRESTON RIDGE RD ALPHARETTA, GA 30005 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY, TENNESSEE | $64 | — | $64 | 3.99% |
| DONALD QUINT3 | 1924 S UTICA STE 710 TULSA, OK 74104 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY, TENNESSEE | $3 | — | $3 | 0.19% |
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 | 4,958 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 4,958 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Short-term disability(2 contracts) | CIGNA GROUP INSURANCE | 98 | $92K |
| Long-term disability(4 contracts, 3 carriers) | CIGNA GROUP INSURANCE | 4,958 | $2.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,958 | — |
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.