| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | HARTFORD LIFE AND ACCIDENT | $652K | $433K | $1.1M | 1.76% |
| WILLIS TOWERS WATSON US LLC4 Filed as: WILLIS TOWERS WATSON PUERTO RICO | THE ATRIUM BUSINESS CENTER STE 310 530 CONSTITUCION AVE. SAN JUAN, PR 009363628 | TRIPLE-S SALUD, INC. | $133K | — | $133K | 5.00% |
| WILLIS TOWERS WATSON US LLC4 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | EYEMED VISION CARE | $87K | — | $87K | 5.48% |
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $17K | — | $17K | 3.02% |
| WILLIS TOWERS WATSON US LLC4 | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | EYEMED VISION CARE | $412 | — | $412 | 0.25% |
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 | 23,331 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 63 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 379 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 23,773 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | TRIPLE-S SALUD, INC. | 390 | $2.7M |
| Dental(2 contracts, 2 carriers) | TRIPLE-S SALUD, INC. | 2,884 | $3.2M |
| Vision(2 contracts) | EYEMED VISION CARE | 28,234 | $1.8M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 23,303 | $61.7M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 23,303 | $61.7M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 23,303 | $61.7M |
| Prescription drug | TRIPLE-S SALUD, INC. | 390 | $2.7M |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 23,303 | $64.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 28,234 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.