| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC. | 233 SOUTH WACKER DR STE 1800 CHICAGO, IL 60606 | MEDICAL MUTUAL | $48K | $25K | $74K | 3.82% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC | 1001 LAKESIDE AVE CLEVELAND, OH 44114 | HARTFORD LIFE AND ACCIDENT | $19K | — | $19K | 12.33% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVC WEST | 801 S FIGUEROA STREET SUITE 800 LOS ANGELES, CA 90017 | HARTFORD LIFE AND ACCIDENT | — | $2K | $2K | 1.39% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 330 W COLLEGE AVE APPLETON, WI 54911 | DELTA DENTAL OF OHIO | $2K | — | $2K | 2.76% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC. | 233 SOUTH WACKER DR STE 1800 CHICAGO, IL 60606 | MEDICAL MUTUAL | $1K | — | $1K | 6.66% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 93245 NETWORK PL CHICAGO, IL 60673 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $216 | — | $216 | 3.46% |
| SMITH, THOMAS, CHRISTOPHER3 | PO BOX 40386 798 BERRY RD NASHVILLE, TN 37204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $92 | — | $92 | 1.47% |
| THE JAMES B OSWALD COMPANY3 | 1100 SUPERIOR AVENUE, SUITE 1500 CLEVELAND, OH 44114 | ACE AMERICAN INSURANCE COMPANY | $306 | $13 | $319 | 15.62% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 93245 NETWORK PL CHICAGO, IL 60673 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $25 | — | $25 | 1.77% |
| SMITH, THOMAS, CHRISTOPHER3 | PO BOX 40386 798 BERRY RD NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.78% |
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 | 168 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 173 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICAL MUTUAL | 125 | $1.9M |
| Dental | DELTA DENTAL OF OHIO | 240 | $72K |
| Vision | MEDICAL MUTUAL | 99 | $15K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 164 | $152K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 164 | $152K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 164 | $152K |
| Prescription drug | MEDICAL MUTUAL | 125 | $1.9M |
| Other(4 contracts, 4 carriers) | HARTFORD LIFE AND ACCIDENT | 168 | $162K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 240 | — |
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.