| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF CALIFORNIA, INC. | I-801 SOUTH FIGUEROA STREET SUITE 800 LOS ANGELES, CA 90017 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $56K | — | $56K | 3.23% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF CALIFORNIA, INC. | PO BOX 101162 PASADENA, CA 91189 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $5K | — | $5K | 4.91% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF CALIFORNIA, INC. | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $3K | $3K | 3.72% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $76 | — | $76 | 0.10% |
| MJ INSURANCE3 Filed as: KAREN NELSON AND VARIOUS AGENTS | 8751 SWALLOW AVENUE FOUNTAIN VALLEY, CA 92708 | AFLAC | $4K | — | $4K | 6.96% |
| MARGARET R WINTERS3 Filed as: MARGARET WINTERS | 6014 GIESEKE DRIVE CRYSTAL LAKE, IL 60014 | AFLAC | $902 | — | $902 | 1.62% |
| JEANETTE FATHERREE3 | 171 COUNTY ROAD 1559 ALBA, TX 75410 | AFLAC | $457 | — | $457 | 0.82% |
| MICHAEL FORNARO3 | 271 US HIGHWAY 46, SUITE H119 FAIRFIELD, NJ 07004 | AFLAC | $344 | — | $344 | 0.62% |
| ZORN BENEFITS GROUP LLC3 Filed as: ZORN BENEFITS GROUP, LLC | 60 US HIGHWAY 46 FAIRFIELD, NJ 07004 | AFLAC | $327 | — | $327 | 0.59% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | AFLAC | $315 | — | $315 | 0.57% |
| KANDI M MCINTYRE3 Filed as: KANDI MCINTYRE | 2000 MALLORY LANE, SUITE 130-378 FRANKLIN, TN 37067 | AFLAC | $289 | — | $289 | 0.52% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF CALIFORNIA, INC. | PO BOX 101162 PASADENA, CA 91189 | VISION SERVICE PLAN | $1K | — | $1K | 5.79% |
| LISA CARNEY3 | 190 NORTH EVERGREEN AVENUE SUITE 206 WOODBURY, NJ 08096 | AFLAC | $183 | — | $183 | 3.06% |
| DONNA S CULLEN3 Filed as: DONNA CULLEN | 317 MAGELLAN DRIVE NEW BERN, NC 28560 | AFLAC | $116 | — | $116 | 1.94% |
| MICHAEL FORNARO3 | 271 US HIGHWAY 46, SUITE H119 FAIRFIELD, NJ 07004 | AFLAC | $81 | — | $81 | 1.35% |
| DARLENE S DILLON3 Filed as: DARLENE DILLON | 282 SHELL ROAD CARNEYS POINT, NJ 08069 | AFLAC | $79 | — | $79 | 1.32% |
| DIANNA L. HONSELL3 Filed as: DIANNA HONSELL | PO BOX 184 ALLOWAY, NJ 08001 | AFLAC | $60 | — | $60 | 1.00% |
| KATHLEEN JUNIKIEWICZ3 | 129 BLUEBELL DRIVE EGG HARBOR TOWNSHIP, NJ 08234 | AFLAC | $38 | — | $38 | 0.63% |
| MICHAEL S CHILLE3 Filed as: MICHAEL CHILLC | 22 CORPORATE WOODS BOULEVARD 4TH FLOOR ALBANY, NY 12211 | AFLAC | $26 | — | $26 | 0.43% |
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 | 161 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 164 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 252 | $1.7M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 135 | $103K |
| Vision | VISION SERVICE PLAN | 140 | $18K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 161 | $76K |
| Short-term disability(2 contracts) | AFLAC | 60 | $62K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 161 | $76K |
| Prescription drug | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 252 | $1.7M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 161 | $132K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 252 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.