| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW JERSEY INC | P.O. BOX 5002 SHORT HILLS, NJ 07078 | HARTFORD LIFE AND ACCIDENT | $38K | — | $38K | 5.71% |
| LIAZON BENEFITS INC3 | 199 SCOTT ST BUFFALO, NY 14204 | HARTFORD LIFE AND ACCIDENT | — | $20K | $20K | 2.98% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 801 S. FIGUEROA STREET, SUITE 800 LOS ANGELES, CA 90017 | HARTFORD LIFE AND ACCIDENT | — | $9K | $9K | 1.37% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | 100 BANK STREET - SUITE 500 BURLINGTON, VT 05401 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | $20K | — | $20K | 3.32% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST, INC | ONE WORLD FINANCIAL CENTER 200 LIBERTY STREET NEW YORK, NY 10281 | HIGHMARK INC. | $12K | — | $12K | 1.90% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST | 1 WORLD FINANCIAL CENTER 200 LIBERTY ST FL 6 NEW YORK, NY 10281 | METROPOLITAN LIFE INSURANCE COMPANY | — | $9K | $9K | 1.47% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW JERSEY INC | 150 JOHN F KENNEDY PARKWAY SHORT HILLS, NJ 07078 | HARTFORD LIFE AND ACCIDENT | $10K | $391 | $11K | 31.15% |
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 | 2,159 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 74 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,242 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 4 carriers) | MERCYCARE INSURANCE COMPANY | 145 | $3.0M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,905 | $599K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 1,644 | $129K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 2,159 | $669K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 2,159 | $669K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 2,159 | $669K |
| Other | HARTFORD LIFE AND ACCIDENT | 2,159 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,159 | — |
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."
No prospect flags tripped on this filing.