| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 233 S WACKER DR, STE 2000 CHICAGO, IL 60606 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $93K | $3K | $97K | 3.99% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 425 NORTH MARTINGALE ROAD SUITE 1100 SCHAUMBURG, IL 60173 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $17K | — | $17K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC. | PO BOX 93225 CHICAGO, IL 60673 | STANDARD INSURANCE COMPANY | $6K | — | $6K | 9.09% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC. | PO BOX 93225 CHICAGO, IL 60673 | STANDARD INSURANCE COMPANY | $4K | — | $4K | 11.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC. | 233 S WACKER, STE 2000 WILLIS TOWER CHICAGO, IL 60606 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $7K | $2K | $9K | 25.03% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 233 S WACKER DR. CHICAGO, IL 60606 | EYEMED VISION CARE | $607 | — | $607 | 3.90% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 233 S WACKER DR #1850 CHICAGO, IL 60606 | FEDERAL INSURANCE COMPANY | $603 | — | $603 | 15.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 233 S WACKER DR, STE 2000 WILLIS TOWER CHICAGO, IL 60606 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | -$14 | — | -$14 | — |
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 | 160 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 162 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 354 | $2.4M |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 164 | $166K |
| Vision | EYEMED VISION CARE | 349 | $16K |
| Life insurance | STANDARD INSURANCE COMPANY | 169 | $62K |
| Long-term disability | STANDARD INSURANCE COMPANY | 169 | $41K |
| Other(5 contracts, 3 carriers) | STANDARD INSURANCE COMPANY | 169 | $102K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 354 | — |
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.