| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO, INC. | 93245 NETWORK PLACE CHICAGO, IL 60673 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $22K | — | $22K | 20.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO, INC. | 93245 NETWORK PLACE CHICAGO, IL 60673 | HM LIFE INSURANCE COMPANY | $10K | — | $10K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST | 93245 NETWORK PLACE CHICAGO, IL 60673 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $905 | $20 | $925 | 2.12% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS, INC. | 233 S WACKER DR STE 2000 CHICAGO, IL 60606 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $668 | — | $668 | 1.53% |
| WORKPLACE SOLUTIONS, INC.3 | 120-A GILLS CREEK PKWY COLUMBIA, SC 29209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $579 | — | $579 | 1.33% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS, INC. | 233 S WACKER DR STE 2000 CHICAGO, IL 60606 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 4.71% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 93245 NETWORK PLACE CHICAGO, IL 60673 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $772 | $13 | $785 | 2.69% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO, INC. | 93245 NETWORK PLACE CHICAGO, IL 60673 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 7.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO, INC. | 93245 NETWORK PLACE CHICAGO, IL 60673 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 13.00% |
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 | 1,210 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,222 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF OHIO | 2,384 | $378K |
| Vision | HM LIFE INSURANCE COMPANY | 850 | $104K |
| Life insurance(3 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,246 | $176K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 32 | $21K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 330 | $92K |
| Other(4 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 1,246 | $109K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,384 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.