| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $12K | $12K | 0.58% |
| WISTED, DANIEL, J3 Filed as: WISTED, DANIEL J. | 3440 PRESTON RIDGE RD STE 325 ALPHARETTA, GA 30005 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $7K | $3K | $10K | 32.36% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE IN | — | CIGNA LIFE INSURANCE CO. OF NEW YORK | — | $71 | $71 | 1.36% |
| DANIEL J WISTED3 | STE 325 3440 PRESTON RIDGE RD ALPHARETTA, GA 30005 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $207 | $2K | 38.96% |
| 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 | $49 | $0 | $49 | 1.11% |
| DONALD QUINT3 Filed as: DONALD PAUL QUINT | 1924 S UTICA STE. STE 710 TULSA, OK 74104 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3 | $0 | $3 | 0.07% |
| 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 | $383 | $77 | $460 | 14.86% |
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 | 5,005 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 5,016 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Short-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 101 | $65K |
| Long-term disability(4 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 5,005 | $2.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,005 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.