| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 525 MARKET ST STE 3400 SAN FRANCISCO, CA 94105 | UNITEDHEALTHCARE INSURANCE COMPANY | $22K | — | $22K | 0.33% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $14K | $1K | $15K | 10.92% |
| PLANSOURCE BENEFITS ADMINISTRATION3 | 101 S GARLAND AVENUE ORLANDO, FL 32801 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 1.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | PO BOX 416672 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $154 | $154 | 0.11% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $13K | $1K | $14K | 10.99% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFITS ADMIN INC | 101 S GARLAND AVENUE SUITE 203 ORLANDO, FL 32801 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 1.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | PO BOX 416672 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $307 | $307 | 0.23% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | $983 | $11K | 10.98% |
| PLANSOURCE BENEFITS ADMINISTRATION3 | 101 S GARLAND AVENUE ORLANDO, FL 32801 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 1.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | PO BOX 416672 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $154 | $154 | 0.15% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | VISION SERVICE PLAN | $4K | — | $4K | 6.50% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $326 | $4K | 11.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | PO BOX 416672 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $307 | $307 | 0.95% |
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 | 625 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 18 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 653 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 306 | $6.6M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 306 | $6.6M |
| Vision | VISION SERVICE PLAN | 394 | $57K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 625 | $131K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 625 | $100K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 625 | $139K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 306 | $6.6M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 625 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 625 | — |
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.