| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | 200 LIBERTY STREET NEW YORK, NY 10281 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $39K | — | $39K | 2.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | 200 LIBERTY STREET NEW YORK, NY 10281 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $17K | — | $17K | 9.30% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | 200 LIBERTY STREET NEW YORK, NY 10281 | WILLAMETTE DENTAL INSURANCE, INC. | $4K | — | $4K | 3.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK, INC. | 1 WORLD FINANCIAL CENTER 200 LIBERTY ST, 6TH FL. NEW YORK, NY 10281 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $8K | — | $8K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | 200 LIBERTY STREET NEW YORK, NY 10281 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $985 | — | $985 | 2.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | ONE WORLD FINANCIAL CENTER 200 LIBERTY STREET NEW YORK, NY 10281 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $756 | — | $756 | 3.22% |
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 | 531 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 541 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 105 | $2.2M |
| Dental(3 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 352 | $2.3M |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 786 | $78K |
| Other(4 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 754 | $2.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 786 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.