| 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 | $115K | $2K | $116K | 4.08% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 425 NORTH MARTINGALE ROAD SUITE 1100 SCHAUMBURG, IL 60173 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $18K | — | $18K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC. | PO BOX 93225 CHICAGO, IL 60673 | STANDARD INSURANCE COMPANY | $9K | — | $9K | 10.85% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA, INC. | PO BOX 101162 PASADENA, CA 91189 | STANDARD INSURANCE COMPANY | — | $385 | $385 | 0.47% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC. | PO BOX 93225 CHICAGO, IL 60673 | STANDARD INSURANCE COMPANY | $6K | — | $6K | 10.86% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA, INC. | PO BOX 101162 PASADENA, CA 91189 | STANDARD INSURANCE COMPANY | — | $262 | $262 | 0.49% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 233 S WACKER, STE 2000 WILLIS TOWER CHICAGO, IL 60606 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $2K | $6K | 23.14% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 233 S WACKER DR. CHICAGO, IL 60606 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $1K | — | $1K | 5.37% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC. | PO BOX 93225 CHICAGO, IL 60673 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 10.99% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | PO BOX 101162 PASADENA, CA 91189 | STANDARD INSURANCE COMPANY | — | $63 | $63 | 0.58% |
| 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 TOWERS WATSON NORTHEAST INC | 200 LIBERTY STREET NEW YORK, NY 10281 | FEDERAL INSURANCE COMPANY | $505 | — | $505 | 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 | 204 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 222 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 408 | $2.9M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 167 | $176K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 437 | $19K |
| Life insurance | STANDARD INSURANCE COMPANY | 201 | $83K |
| Short-term disability | STANDARD INSURANCE COMPANY | 37 | $11K |
| Long-term disability | STANDARD INSURANCE COMPANY | 200 | $54K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ILLINOIS | 408 | $2.9M |
| Other(4 contracts, 3 carriers) | STANDARD INSURANCE COMPANY | 204 | $116K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 437 | — |
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.