| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS. OF CA, INC. | 18101 VON KARMAN AVE., 6TH FLOOR IRVINE, CA 92612 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $63K | $3K | $66K | 3.25% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $5K | $35 | $5K | 12.33% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS. OF CA, INC. | 18101 VON KARMAN AVE., 6TH FLOOR IRVINE, CA 92612 | VISION SERVICE PLAN | $869 | — | $869 | 5.75% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $352 | — | $352 | 9.45% |
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 | 160 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 160 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 124 | $2.0M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 124 | $2.0M |
| Vision | VISION SERVICE PLAN | 129 | $15K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 159 | $65K |
| Short-term disability(2 contracts) | AFLAC | 48 | $41K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 159 | $23K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 124 | $2.0M |
| Other(3 contracts, 2 carriers) | AFLAC | 159 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 159 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.