| 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 | $137K | — | $137K | 3.43% |
| 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 | — | $43K | $43K | 1.07% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 93245 NETWORK PLACE CHICAGO, IL 60673 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $48K | — | $48K | 18.36% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 93245 NETWORK PLACE CHICAGO, IL 60673 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $47K | — | $47K | 20.03% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 93245 NETWORK PLACE CHICAGO, IL 60673 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $34K | — | $34K | 18.25% |
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 | 4,870 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 33 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 47 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,950 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN, INC. | 397 | $4.4M |
| Vision | COMMUNITY INSURANCE COMPANY | 6,185 | $336K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 5,284 | $4.0M |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 5,284 | $4.0M |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 5,284 | $4.0M |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN, INC. | 397 | $4.4M |
| Other(4 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 5,284 | $4.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,185 | — |
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."
No prospect flags tripped on this filing.