| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| 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 | $12K | — | $12K | 2.00% |
| 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 | — | $7K | $7K | 1.17% |
| 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 | $44K | — | $44K | 14.98% |
| 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 | 0.98% |
| 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 | $21K | — | $21K | 15.01% |
| 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 | — | $6K | $6K | 4.01% |
| 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 | $13K | — | $13K | 10.00% |
| 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 | $19K | — | $19K | 14.99% |
| 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 | — | $6K | $6K | 4.38% |
| 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 | $8K | — | $8K | 10.00% |
| 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 | 4.31% |
| 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 | — | $2K | $2K | 2.18% |
| UTIC INSURANCE COMPANY3 | 450 RIVERCHASE PKWY E BIRMINGHAM, AL 35244 | SUN LIFE ASSURANCE COMPANY OF CANADA | $10K | — | $10K | 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 | $2K | — | $2K | 14.99% |
| 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 | — | $333 | $333 | 2.20% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | 200 LIBERTY STREET, 7TH FL NEW YORK, NY 102811003 | NATIONAL UNION FIRE INS CO OF PITTSBURGH, PA | $2K | — | $2K | 25.00% |
| 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 | $26 | — | $26 | 4.06% |
| 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 | — | $15 | $15 | 2.34% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTH CARE INSURANCE CO EIN 52-2370901 NONE | Claims processing; Other services; Contract Administrator; Direct payment from the plan Service code 12 | — | $316K |
| BLUE CROSS & BLUE SHIELD OF ALABAMA EIN 63-0103830 NONE | Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | — | $65K |
| DELTA DENTAL OF OHIO EIN 31-0685339 NONE | Contract Administrator; Direct payment from the plan; Claims processing Service code 12 | — | $51K |
| CONNECTYOURCARE EIN 46-0891463 NONE | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 13 | — | $12K |
| 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 NONE | Trustee (directed); Trustee (bank, trust company, or similar financial institution); Direct payment from the plan Service code 21 | — | $2K |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 1,245 | $125K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,965 | $371K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,965 | $599K |
| Long-term disability(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 496 | $129K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 1,281 | $1.4M |
| Other(6 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,158 | $402K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,158 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.