| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 111 EAST KILBOURN AVENUE MILWAUKEE, WI 53202 | COMMUNITY INSURANCE COMPANY | $18K | — | $18K | 1.11% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SERV | 2055 GATEWAY PLACE STE 450 SAN JOSE, CA 95110 | COMMUNITY INSURANCE COMPANY | — | $308 | $308 | 0.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO-CLEV DIV | 1001 LAKESIDE AVE E STE 1500 CLEVELAND, OH 441141151 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | — | $5K | 4.06% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 111 EAST KILBOURN AVENUE, STE 1850 MILWAUKEE, WI 53202 | STANDARD INSURANCE COMPANY | $8K | — | $8K | 13.32% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SERV | PO BOX 101162 PASADENA, CA 91189 | STANDARD INSURANCE COMPANY | — | $2K | $2K | 2.51% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 400 NORTH EXECUTIVE DRIVE SUITE 30 BROOKFIELD, WI 53005 | ANTHEM LIFE INSURANCE COMPANY (G1400) | $8K | — | $8K | 13.59% |
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 | 225 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 226 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITY INSURANCE COMPANY | 280 | $1.6M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 298 | $131K |
| Vision | COMMUNITY INSURANCE COMPANY | 280 | $1.6M |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 225 | $123K |
| Short-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 225 | $123K |
| Long-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 225 | $123K |
| Other(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 225 | $123K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 298 | — |
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.