| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF GA | LOCKBOX 905260 806 TYVOLA ROAD, STE. 108 CHARLOTTE, NC 28217 | STANDARD INSURANCE COMPANY | $47K | — | $47K | 3.66% |
| JOHN C OLIVER JR3 | 233 CAJON ST SUITE 7 REDLANDS, CA 92373 | STANDARD INSURANCE COMPANY | $3K | — | $3K | 0.24% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS. SERVICES OF GEORGIA | 806 TYVOLA ROAD SUITE 108 CHARLOTTE, NC 28217 | VISION SERVICE PLAN | $8K | — | $8K | 1.99% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF GA | LOCKBOX 905260 806 TYVOLA ROAD, STE. 108 CHARLOTTE, NC 28217 | STANDARD INSURANCE COMPANY | $12K | — | $12K | 3.66% |
| JOHN C OLIVER JR3 | 233 CAJON ST SUITE 7 REDLANDS, CA 92373 | STANDARD INSURANCE COMPANY | $798 | — | $798 | 0.24% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SERVICES OF GEORGIA | PO BOX 905260 CHARLOTTE, NC 282905260 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $27K | — | $27K | 11.74% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SERVICES OF GEORGIA | PO BOX 905260 CHARLOTTE, NC 282905260 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 11.82% |
| JOHN C OLIVER JR3 Filed as: JOHN C. OLIVER | 233 CAJON STREET SUITE 7 REDLANDS, CA 92373 | GERBER LIFE & ACCIDENT INSURANCE COMPANY | $983 | — | $983 | 12.47% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURNCE SERVICES OF GEORGIA | 5 CONCOURSE CORPORATE CENTER NE SUITE 1800 ATLANTA, GA 30328 | GERBER LIFE & ACCIDENT INSURANCE COMPANY | $200 | — | $200 | 2.54% |
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 | 3,181 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 35 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 43 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,259 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 8 | $270K |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 8 | $270K |
| Vision | VISION SERVICE PLAN | 3,218 | $417K |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 3,180 | $1.3M |
| Long-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 31,841 | $357K |
| Other(4 contracts, 4 carriers) | STANDARD INSURANCE COMPANY | 3,181 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 31,841 | — |
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.