| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF PENNSYLVANIA, INC. | 100 MATSONFORD RD BLDG 5, STE 200 RADNOR, PA 19087 | HARVARD PILGRIM HEALTH CARE | $18K | — | $18K | 1.05% |
| AISLING PARTNERS INSURANCE BROKERAG3 Filed as: AISLING PARTNERS INS BROKERAGE | 25 HARVARD ST WORCESTER, MA 01609 | HARVARD PILGRIM HEALTH CARE | $93 | — | $93 | 0.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF PA INSURANCE SVCS | 100 MATSONFORD RD BLDG 5, STE 200 WAYNE, PA 19087 | DENTAL SERVICE OF MASSACHUSETTS, INC. D/B/A DELTA DENTAL OF MA | $13K | — | $13K | 2.39% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF PENNSYLVANIA, INC. | 100 MATSONFORD RD STE 200 BLDG 5 RADNOR, PA 19087 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $2K | $11K | 7.52% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF PENNSYLVANIA, INC. | PO BOX 32090 NEW YORK, NY 10087 | VISION SERVICE PLAN | $2K | — | $2K | 3.61% |
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 | 304 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 311 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARVARD PILGRIM HEALTH CARE | 584 | $1.7M |
| Dental | DENTAL SERVICE OF MASSACHUSETTS, INC. D/B/A DELTA DENTAL OF MA | 1,314 | $557K |
| Vision | VISION SERVICE PLAN | 366 | $53K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 194 | $145K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 194 | $145K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 194 | $145K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 194 | $145K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,314 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.