| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TEXAS, INC | 15305 N. DALLAS PARKWAY SUITE 1100 ADDISON, TX 75001 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $61K | — | $61K | 8.33% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TEXAS, INC. | P.O. BOX 731739 DALLAS, TX 75373 | METROPOLITAN LIFE INSURANCE COMPANY | $17K | $3K | $20K | 11.83% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TEXAS, INC | 15305 N. DALLAS PARKWAY SUITE 1100 ADDISON, TX 75001 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | $2K | $11K | 18.45% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TEXAS, INC | 15305 N. DALLAS PARKWAY SUITE 1100 ADDISON, TX 75001 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | $2K | $10K | 18.09% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TEXAS, INC | 15305 N. DALLAS PARKWAY SUITE 1100 ADDISON, TX 75001 | VISION SERVICE PLAN | $2K | — | $2K | 7.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TEXAS, INC | 15305 N. DALLAS PARKWAY SUITE 1100 ADDISON, TX 75001 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $665 | $144 | $809 | 18.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 SERVICE PROVIDER | Contract Administrator; Named fiduciary; Direct payment from the plan; Non-monetary compensation; Claims processing; Float revenue; Other services; Participant communication Service code 12 | 900 COTTAGE GROVE ROAD BLOOMFIELD, CT 06002 | $94K |
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 | 125 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 125 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 115 | $737K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 490 | $172K |
| Vision | VISION SERVICE PLAN | 95 | $24K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 117 | $56K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 78 | $60K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 61 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 490 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.