| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 233 S WACKER DR STE 2000 CHICAGO, IL 60606 | SUN LIFE ASSURANCE COMPANY OF CANADA | $54K | — | $54K | 3.70% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 525 MARKET ST SUITE 3400 SAN FRANCISCO, CA 94105 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $13K | $13K | 0.89% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 35371 NETWORK PLACE CHICAGO, IL 60673 | VISION SERVICE PLAN | $4K | — | $4K | 2.10% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 233 SOUTH WACKER DRIVE SUITE 2000 CHICAGO, IL 60606 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $424 | $54 | $478 | 11.26% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $360 | $360 | 8.48% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10005 | FOUR EVER LIFE INS CO. | $449 | — | $449 | 15.02% |
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 | 1,674 | 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) | 1,674 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | FOUR EVER LIFE INS CO. | 1,674 | $3K |
| Vision | VISION SERVICE PLAN | 1,275 | $174K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,886 | $1.5M |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,886 | $1.5M |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,886 | $1.5M |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,886 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,886 | — |
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.