| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC. | 233 SOUTH WACKER, STE 2000 CHICAGO, IL 60606 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $34K | $3K | $36K | 1.21% |
| DS&P INSURANCE SERVICES, INC.3 | 1900 E. GOLF ROAD-SUITE 650 SCHAUMBURG, IL 60173 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $24K | — | $24K | 0.81% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MARYLAND INC | 225 SCHILLING CIR, STE 150 HUNT VALLEY, MD 21031 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $8K | — | $8K | 4.51% |
| DS&P INSURANCE SERVICES, INC.3 | 1900 E. GOLF ROAD-SUITE 650 SCHAUMBURG, IL 60173 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $5K | — | $5K | 2.40% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MARYLAND, INC. | PO BOX 13784 NEWARK, NJ 07188 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $1K | $1K | 0.79% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS | 425 N. MARTINGALE ROAD-STE. 1100 SCHAUMBURG, IL 601732237 | RELIASTAR LIFE INSURANCE COMPANY | $13K | — | $13K | 8.52% |
| DS&P INSURANCE SERVICES, INC.3 | 1900 E. GOLF ROAD-SUITE 650 SCHAUMBURG, IL 60173 | RELIASTAR LIFE INSURANCE COMPANY | $8K | — | $8K | 5.43% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS | 233 SOUTH WACKER DRIVE-SUITE 2000 CHICAGO, IL 60606 | EYEMED VISION CARE | $874 | — | $874 | 4.61% |
| DSP INSURANCE SERVICES, INC.3 | 1900 E. GOLF ROAD-#650 SCHAUMBURG, IL 60173 | EYEMED VISION CARE | $446 | — | $446 | 2.35% |
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 | 279 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 282 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 459 | $3.0M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 247 | $188K |
| Vision | EYEMED VISION CARE | 329 | $19K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 279 | $153K |
| Short-term disability | RELIASTAR LIFE INSURANCE COMPANY | 279 | $153K |
| Long-term disability | RELIASTAR LIFE INSURANCE COMPANY | 279 | $153K |
| Other | RELIASTAR LIFE INSURANCE COMPANY | 279 | $153K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 459 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.