| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC4 | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 100878852 | SUN LIFE ASSURANCE COMPANY OF CANADA | $104K | $57K | $161K | 4.87% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 COMMISSION LOCKBOX #28852 NEW YORK, NY 10087 | RELIASTAR LIFE INSURANCE COMPANY | $170K | — | $170K | 6.00% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 100878852 | RELIASTAR LIFE INSURANCE COMPANY | $260K | — | $260K | 65.61% |
| BSC AGENCY LLC3 | 1025 ASHWORTH RD WEST DES MOINES, IA 50265 | RELIASTAR LIFE INSURANCE COMPANY | — | $16K | $16K | 4.00% |
| WILLIS TOWERS WATSON US LLC4 | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 100878852 | ARAG INSURANCE COMPANY | $14K | — | $14K | 12.75% |
| WILLIS TOWERS WATSON US LLC4 | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $745 | — | $745 | 2.58% |
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 | 4,004 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 41 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 66 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,111 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | TRIPLE S SALUD INC | 75 | $664K |
| Dental(2 contracts, 2 carriers) | TRIPLE S SALUD INC | 494 | $722K |
| Vision(3 contracts, 2 carriers) | TRIPLE S SALUD INC | 6,102 | $989K |
| Life insurance(2 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 3,376 | $3.3M |
| Short-term disability(2 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 3,376 | $3.3M |
| Long-term disability(2 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 3,376 | $3.3M |
| Prescription drug(2 contracts, 2 carriers) | TRIPLE S SALUD INC | 75 | $664K |
| Stop-loss / reinsurancereinsurance | RELIASTAR LIFE INSURANCE COMPANY | 3,221 | $2.8M |
| Other(5 contracts, 4 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 3,376 | $3.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,102 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.