| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $7K | $4K | $10K | 2.36% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 80 SOUTH 8TH ST MINNEAPOLIS, MN 55402 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $5K | $3K | $8K | 1.90% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | PO BOX 28852 NEW YORK, NY 100878852 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 0.89% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $4K | $2K | $6K | 2.35% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 80 SOUTH 8TH ST MINNEAPOLIS, MN 55402 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $4K | $2K | $5K | 1.96% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $3K | $2K | $5K | 2.35% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 80 SOUTH ST MINNEAPOLIS, MN 55402 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $3K | $1K | $4K | 1.94% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | PO BOX 28852 NEW YORK, NY 100878852 | SELECTHEALTH | $2K | — | $2K | 1.28% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | PO BOX 28852 NEW YORK, NY 100878852 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | $1K | $8K | 7.17% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP | 1125 17TH ST STE 1710 DENVER, CO 802022061 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | $69 | $7K | 6.26% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 554022105 | METROPOLITAN LIFE INSURANCE COMPANY | — | $381 | $381 | 0.33% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | PO BOX 28852 NEW YORK, NY 100878852 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $794 | $5K | 7.14% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | 1125 17TH ST STE 1710 DENVER, CO 802022061 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $69 | $5K | 6.24% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 554022105 | METROPOLITAN LIFE INSURANCE COMPANY | — | $245 | $245 | 0.33% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | PO BOX 28852 NEW YORK, NY 100878852 | SELECTHEALTH | $2K | — | $2K | 12.04% |
| ELIZABETH FULTON3 | PO BOX 1047 GLENWOOD SPRINGS, CO 81602 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 4.50% |
| GINA WESOLEK3 | 114 LAKEWOOD CIRCLE WOODLAND PARK, CO 80863 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.50% |
| WILLIAM T MILLER3 | 2908 OTRANTO ROAD NORTH CHARLESTON, SC 29406 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.50% |
| ROBERT P BARBATI3 | 1078 N SHADOW DR MT PLEASANT, SC 29464 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.50% |
| RAY MCMARTIN3 | 8045 TABLE MESA WAY COLORADO SPRINGS, CO 80919 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.50% |
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 | 4,006 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 47 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,053 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(8 contracts, 5 carriers) | PROVIDENCE HEALTH PLAN | 555 | $3.2M |
| Dental(4 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | 3,948 | $3.6M |
| Vision | VISION SERVICE PLAN | 3,777 | $275K |
| Life insurance(2 contracts, 2 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 4,061 | $446K |
| Short-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 821 | $218K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,622 | $275K |
| Prescription drug(7 contracts, 4 carriers) | PROVIDENCE HEALTH PLAN | 336 | $3.1M |
| Other(2 contracts, 2 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 4,061 | $561K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,061 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.