| 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 | $13K | — | $13K | 0.77% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE IN | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | CIGNA GROUP INSURANCE | $736 | — | $736 | 1.98% |
| WISTED, DANIEL, J3 Filed as: WISTED, DANIEL J. | 3440 PRESTON RIDGE RD STE 325 ALPHARETTA, GA 30005 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $9K | — | $9K | 29.07% |
| 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 | $39 | — | $39 | 1.24% |
| 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 | $459 | — | $459 | 14.83% |
| WISTED, DANIEL, J3 Filed as: WISTED, DANIEL J; | STE 325 3440 PRESTON RIDGE RD ALPHARETTA, GA 30005 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $332 | — | $332 | 10.72% |
| 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 | $78 | — | $78 | 4.86% |
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 | 4,799 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 4,799 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Short-term disability(2 contracts) | CIGNA GROUP INSURANCE | 95 | $40K |
| Long-term disability(4 contracts, 3 carriers) | CIGNA GROUP INSURANCE | 4,799 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,799 | — |
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.