| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MJ INSURANCE3 Filed as: VARIOUS AGENTS-SEE ATTACHMENT | PO BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $36K | $2K | $38K | 13.54% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 920 MEMORIAL CITY WAY STE 500 HOUSTON, TX 77024 | SUN LIFE ASSURANCE COMPANY OF CANADA | $4K | — | $4K | 2.57% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 731739 DALLAS, TX 75373 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | — | $3K | 1.58% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $1K | $1K | 0.76% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON | 9043 SANDSTONE ST HOUSTON, TX 77036 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $31K | — | $31K | 20.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 811 LOUISIANA ST STE 2200 HOUSTON, TX 77002 | UNITEDHEALTHCARE INSURANCE COMPANY | $6K | — | $6K | 12.57% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 920 MEMORIAL CITY WAY STE 500 HOUSTON, TX 77024 | SUN LIFE ASSURANCE COMPANY OF CANADA | $6K | — | $6K | 15.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $622 | $622 | 1.52% |
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 | 781 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 35 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 817 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 349 | $170K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 435 | $47K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 840 | $198K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 193 | $283K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 268 | $157K |
| Other(3 contracts, 3 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 840 | $482K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 840 | — |
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.