| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC | 330 W COLLEGE AVE APPLETON, WI 54911 | DELTA DENTAL OF OHIO | $12K | — | $12K | 4.57% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS | 233 S WACKER DR, STE 2000 CHICAGO, IL 60606 | DELTA DENTAL OF OHIO | $6K | — | $6K | 2.50% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC | 233 S WACKER DR STE 2000 CHICAGO, IL 60606 | HARTFORD LIFE AND ACCIDENT | $14K | — | $14K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 233 S WACKER DR, STE 2000 CHICAGO, IL 60606 | AETNA LIFE INSURANCE CO. | $7K | — | $7K | 9.94% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC | 233 S WACKER DR STE 2000 CHICAGO, IL 60606 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $31 | $8K | 16.85% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC. | 233 S WACKER DR, STE 2000 CHICAGO, IL 60606 | METROPOLITAN LIFE INSURANCE COMPANY | $826 | $206 | $1K | 2.22% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO INC | 775 YARD ST STE 200 COLUMBUS, OH 43212 | METROPOLITAN LIFE INSURANCE COMPANY | — | $488 | $488 | 1.05% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC | 233 S WACKER DR STE 2000 CHICAGO, IL 60606 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $2K | — | $2K | 5.86% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS, INC. | 233 S WACKER DR, STE 2000 CHICAGO, IL 60606 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $717 | — | $717 | 1.78% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO INC | 775 YARD ST STE 200 COLUMBUS, OH 43212 | METROPOLITAN LIFE INSURANCE COMPANY | — | $366 | $366 | 0.94% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 233 S WACKER DR STE 2000 CHICAGO, IL 60606 | METROPOLITAN LIFE INSURANCE COMPANY | — | $113 | $113 | 0.29% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC. | 233 S WACKER DR STE 2000 CHICAGO, IL 60606 | METROPOLITAN LIFE INSURANCE COMPANY | — | $31 | $31 | 0.08% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC | 233 S WACKER DR STE 2000 CHICAGO, IL 60606 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $31 | $3K | 17.15% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 233 S WACKER DR, STE 2000 CHICAGO, IL 60606 | METROPOLITAN LIFE INSURANCE COMPANY | $336 | $104 | $440 | 2.91% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO INC | 775 YARD ST STE 200 COLUMBUS, OH 43212 | METROPOLITAN LIFE INSURANCE COMPANY | — | $160 | $160 | 1.06% |
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 | 429 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 14 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 445 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 12 | $73K |
| Dental | DELTA DENTAL OF OHIO | 843 | $257K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 704 | $40K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 429 | $209K |
| Long-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 429 | $209K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 12 | $73K |
| Other(5 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 429 | $310K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 843 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.