| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SERV | 500 N AKARD STREET SUITE 4300 DALLAS, TX 75201 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $19K | $19K | 2.81% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 775 YARD STREET SUITE 20 COLUMBUS, OH 43212 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $11K | — | $11K | 1.56% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 775 YARD STREET SUITE 200 COLUMBUS, OH 43212 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $45K | — | $45K | 13.66% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SERV | 500 N AKARD STREET SUITE 4300 DALLAS, TX 75201 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $8K | $8K | 2.54% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 775 YARD STREET SUITE 200 COLUMBUS, OH 43212 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 2.61% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SERV | 500 N AKARD STREET SUITE 4300 DALLAS, TX 75201 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $950 | $950 | 0.68% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SERV | 500 N AKARD STREET SUITE 4300 DALLAS, TX 75201 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $3K | $3K | 3.40% |
| UTIC INSURANCE COMPANY3 | 450 RIVERCHASE PKWY E BIRMINGHAM, AL 35244 | SUN LIFE ASSURANCE COMPANY OF CANADA | $9K | — | $9K | 15.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 775 YARD STREET SUITE 200 COLUMBUS, OH 43212 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $31 | — | $31 | 4.03% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLS TOWERS WATSON INSURANCE SERV | 500 N AKARD STREET SUITE 4300 DALLAS, TX 75201 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $27 | $27 | 3.51% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTH CARE INSURANCE CO EIN 52-2370901 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator; Other services; Direct payment from the plan Service code 12 | — | $278K |
| BLUE CROSS & BLUE SHIELD OF ALABAMA EIN 63-0103830 CONTRACT ADMINISTRATOR | Contract Administrator; Direct payment from the plan; Claims processing Service code 12 | — | $64K |
| DELTA DENTAL OF OHIO EIN 31-0685339 CONTRACT ADMINISTRATOR | Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | — | $50K |
| ARY ROEPCKE MULCHAEY, P.C. EIN 52-2370901 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $18K |
| CONNECTYOURCARE EIN 46-0891463 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan; Contract Administrator Service code 13 | — | $14K |
| CANCER BRIDGE EIN 47-1868769 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $9K |
| HUNTINGTON NATIONAL BANK & TRUST CO EIN 31-0966785 TRUSTEE | Trustee (bank, trust company, or similar financial institution); Trustee (directed); Direct payment from the plan Service code 21 | — | $3K |
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 | 1,216 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,220 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 1,116 | $122K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 3,453 | $409K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,778 | $676K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 4 | $770 |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 1,139 | $1.2M |
| Other(3 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 3,453 | $267K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,453 | — |
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."
No prospect flags tripped on this filing.