| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | LOCKBOX 741909 PO BOX 741909 ATLANTA, GA 303741909 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $49K | — | $49K | 3.02% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $15K | — | $15K | 0.94% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $707 | $707 | 0.04% |
| EVEREST FUNERAL PACKAGE LLC5 | 1300 POST OAK BLVD SUITE 1210 HOUSTON, TX 770563163 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $79 | $79 | 0.00% |
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 | 2,075 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,091 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision(2 contracts) | PRINCIPAL LIFE INSURANCE COMPANY | 3,016 | $370K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,075 | $1.6M |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,075 | $1.6M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,075 | $1.6M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,075 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,016 | — |
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.