| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| 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 | — | $6K | $6K | 0.74% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM & ASSOCIATES | 500 WEST 13TH STREET FT. WORTH, TX 76102 | EYEMED VISON CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS CO | -$152 | — | -$152 | -0.23% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SERVICE | 500 N AKARD STREET SUITE 4300 DALLAS, TX 75201 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $777 | $5K | 11.89% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SERVICE | 500 N AKARD STREET SUITE 4300 DALLAS, TX 75201 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $666 | $4K | 11.97% |
| WILLIS TOWERS WATSON US LLC4 Filed as: WILLIS TOWERS WATSON MIDWEST INC. | 93033 NETWORK PL CHICAGO, IL 60673 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $6K | — | $6K | 17.00% |
| SCOTT BECK4 | APT 13G 6 PETER COOPER RD NEW YORK, NY 10010 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $648 | — | $648 | 2.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SERVICE | 500 N AKARD STREET SUITE 4300 DALLAS, TX 75201 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $386 | $3K | 11.79% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 525 MARKET ST SUITE 3400 SAN FRANCISCO, CA 94105 | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | — | $80 | $80 | 1.44% |
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 | 1,106 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 21 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 36 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,163 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,116 | $770K |
| Vision | EYEMED VISON CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS CO | 1,309 | $67K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,116 | $770K |
| Short-term disability | SUN LIFE AND HEALTH INSURANCE COMPANY (U.S.) | 65 | $6K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,116 | $770K |
| Other(5 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,116 | $898K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,309 | — |
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.