| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | PO BOX 13784 NEWARK, NJ 07188 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $133K | $133K | 4.15% |
| HAMILTON INSURANCE AGENCY3 Filed as: HAMILTON INSURANCE AGENCY T/A | 4100 MONUMENT CORNER DR SUITE 500 FAIRFAX, VA 22030 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $27K | $27K | 0.85% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 225 SCHILLING CIR STE 150 HUNT VALLEY, MD 21031 | AMERITAS LIFE INSURANCE CORP. | $22K | — | $22K | 10.00% |
| ALAN J ZUCCARI INC3 | 4100 MONUMENT CORNER DR STE 500 FAIRFAX, VA 22030 | AMERITAS LIFE INSURANCE CORP. | $11K | — | $11K | 5.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA INC | 214 N TRYON ST STE 2500 HEARST TOWER CHARLOTTE, NC 28202 | AMERITAS LIFE INSURANCE CORP. | — | $2K | $2K | 0.99% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 12505 PARK POTOMAC AVE STE 300 POTOMAC, MD 20854 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $16K | — | $16K | 10.00% |
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 | 137 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 138 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 147 | $3.2M |
| Dental | AMERITAS LIFE INSURANCE CORP. | 332 | $222K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 332 | $222K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 160 | $160K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 160 | $160K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 160 | $160K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 147 | $3.2M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 160 | $160K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 332 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.