| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC | 400 N EXECUTIVE DR STE 300 BROOKFIELD, WI 53005 | DEAN HEALTH PLAN INC | $18K | — | $18K | 1.40% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST | 400 N EXECUTIVE DR STE 300 BROOKFIELD, WI 53005 | DELTA DENTAL OF WISCONSIN | $5K | — | $5K | 9.82% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 93033 NETWORK PLACE CHICAGO, IL 60673 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 9.26% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SVCS | 500 N AKARD STREET SUITE 4300 DALLAS, TX 75201 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $507 | $507 | 1.14% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 93033 NETWORK PL CHICAGO, IL 60673 | VISION SERVICE PLAN | $637 | — | $637 | 8.31% |
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 | 171 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 77 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 248 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | DEAN HEALTH PLAN INC | 93 | $1.3M |
| Dental | DELTA DENTAL OF WISCONSIN | 83 | $48K |
| Vision | VISION SERVICE PLAN | 102 | $8K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 198 | $45K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 198 | $45K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 198 | $45K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 198 | $45K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 198 | — |
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.