| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 775 YARD ST SUITE 200 COLUMBUS, OH 43212 | SUN LIFE ASSURANCE COMPANY OF CANADA | $74K | — | $74K | 9.32% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 525 MARKET ST SUITE 3400 SAN FRANCISCO, CA 94105 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $10K | $10K | 1.25% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 111 EAST KILBOURN AVENUE SUITE 1850 MILWAUKEE, WI 53202 | ANTHEM HEALTH PLANS OF KY, INC. | $29K | — | $29K | 5.11% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 300 S GRAND AVE STE 2000 LOS ANGELES, CA 90071 | ANTHEM HEALTH PLANS OF KY, INC. | — | $8K | $8K | 1.38% |
| WATSON PR INS BROKER3 | THE ATRIUM BUSINESS CTR. 530 AVE. CONSTITUCION S 310 SAN JUAN, PR 00901 | HUMANA INSURANCE OF PUERTO RICO, INC. | $986 | — | $986 | 4.59% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON PUERTO RICO | THE ATRIUM BUSINESS CENTER 530 CONSTITUCION AVE. SAN JUAN, PR 00901 | TRIPLE S SALUD, INC. | $730 | — | $730 | 5.00% |
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 | 770 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 11 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 790 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HUMANA INSURANCE OF PUERTO RICO, INC. | 6 | $36K |
| Dental | ANTHEM HEALTH PLANS OF KY, INC. | 1,436 | $568K |
| Vision | ANTHEM HEALTH PLANS OF KY, INC. | 1,436 | $568K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,166 | $799K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,166 | $799K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,166 | $799K |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,394 | $830K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,436 | — |
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.