| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST | 12505 PARK POTOMAC AVENUE SUITE 300 POTOMAC, MD 208546804 | SYMETRA LIFE INSURANCE COMPANY | — | $8K | $8K | 0.68% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 4951 LAKE BROOK DRIVE SUITE 300 GLEN ALLEN, VA 23060 | HARTFORD LIFE AND ACCIDENT | $81K | — | $81K | 13.89% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | 801 S FIGUEROA STREET SUITE 800 LOS ANGELES, CA 90017 | HARTFORD LIFE AND ACCIDENT | — | $10K | $10K | 1.68% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 4951 LAKE BROOK DRIVE SUITE 300 GLEN ALLEN, VA 23060 | DELTA DENTAL OF VIRGINIA | $25K | — | $25K | 5.51% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 12505 PARK POTOMAC AVENUE SUITE 300 POTOMAC, MD 208546804 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $15K | — | $15K | 10.84% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | PO BOX 13784 NEWARK, NJ 071883784 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | $34 | $7K | 16.71% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE INC | 26 CENTURY BLVD C/O JP MORGAN CHASE NASHVILLE, TN 372143685 | METROPOLITAN LIFE INSURANCE COMPANY | — | $517 | $517 | 1.16% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 29727 NETWORK PLACE CHICAGO, IL 60673 | HARTFORD LIFE AND ACCIDENT | $6K | $480 | $7K | 16.20% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | PO BOX 13784 NEWARK, NJ 071883784 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $34 | $6K | 16.15% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE INC | 26 CENTURY BLVD C/O JP MORGAN CHASE NASHVILLE, TN 372143685 | METROPOLITAN LIFE INSURANCE COMPANY | — | $416 | $416 | 1.11% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | PO BOX 13784 NEWARK, NJ 071883784 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $34 | $6K | 16.80% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE INC | 26 CENTURY BLVD C/O JP MORGAN CHASE NASHVILLE, TN 372143685 | METROPOLITAN LIFE INSURANCE COMPANY | — | $467 | $467 | 1.35% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | PO BOX 13784 NEWARK, NJ 071883784 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $34 | $3K | 15.93% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE INC | 26 CENTURY BLVD C/O JP MORGAN CHASE NASHVILLE, TN 372143685 | METROPOLITAN LIFE INSURANCE COMPANY | — | $264 | $264 | 1.31% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | PO BOX 13784 NEWARK, NJ 071883784 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $34 | $3K | 17.15% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE INC | 26 CENTURY BLVD C/O JP MORGAN CHASE NASHVILLE, TN 372143685 | METROPOLITAN LIFE INSURANCE COMPANY | — | $216 | $216 | 1.42% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILL TOWERS WATSON SOUTHEAST INC | 12505 PARK POTOMAC AVENUE SUITE 300 POTOMAC, MD 208546804 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $274 | — | $274 | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | PO BOX 13784 NEWARK, NJ 071883784 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | — |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE INC | 26 CENTURY BLVD C/O JP MORGAN CHASE NASHVILLE, TN 372143685 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3K | $3K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 MEDICAL/RX ADMINISTRATOR | Contract Administrator; Direct payment from the plan; Other services; Participant communication; Claims processing; Non-monetary compensation; Named fiduciary; Float revenue Service code 12 | — | $705K |
| GOVERNMENT SERVICE CONTRACTORS EIN 11-3335620 RECORDKEEPER | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $468K |
| HARTFORD LIFE AND ACCIDENT INS CO EIN 06-0838648 ADAAA/FMLA MANAGEMENT | Participant communication; Contract Administrator; Other services Service code 13 | — | $93K |
| HEALTH ADVOCATE SOLUTIONS INC EIN 23-3080019 HEALTH CARE CONCIERGE | Contract Administrator; Other services; Participant communication Service code 13 | — | $38K |
| TELUS HEALTH LTD EIN 52-1883918 EAP ADMINISTRATOR | Participant communication; Contract Administrator; Other services Service code 13 | 250 ROYALL STREET SUITE 210W CANTON, MA 02021 | $37K |
| BANK OF AMERICA EIN 94-1687665 TRUSTEE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Trustee (discretionary) Service code 15 | — | $12K |
| FLORES AND ASSOCIATES EIN 56-1542307 HSA/FSA/COBRA ADMIN | Other services; Contract Administrator; Participant communication Service code 13 | — | $11K |
| CIGNA | Other services; Direct payment from the plan; Contract Administrator; Participant communication; Float revenue; Named fiduciary; Non-monetary compensation; Claims processing Service code 12 | — | $0 |
| WILLIS TOWERS WATSON SOUTHEAST INC EIN 62-1404453 BROKER | Insurance agents and brokers Service code 22 | — | $0 |
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 | 1,482 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,486 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 10 | $140K |
| Dental(3 contracts, 3 carriers) | DELTA DENTAL OF VIRGINIA | 1,012 | $599K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 4,093 | $584K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 4,093 | $584K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 4,093 | $584K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 1,154 | $1.2M |
| Other(8 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,551 | $335K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,093 | — |
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.