| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC. | 233 S WACKER DR STE 2000 WILLIS TOWER CHICAGO, IL 60606 | BLUECROSS BLUESHIELD OF ILLINOIS | $44K | — | $44K | 3.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC | 400 N EXECUTIVE DRIVE STE 300 BROOKFIELD, WI 53005 | BLUECROSS BLUESHIELD OF ILLINOIS | $12K | — | $12K | 0.83% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: EMPLOYEE BENEFIT RISK MGMT | UNKNOWN BROOKFIELD, WI 53005 | BLUECROSS BLUESHIELD OF ILLINOIS | $9K | — | $9K | 0.61% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 400 N EXECUTIVE DR STE 300 BROOKFIELD, WI 53005 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 5.03% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA INC | BANC ONE DEPT 100485 PASADENA, CA 91189 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $3K | $3K | 2.37% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC | 93033 NETWORK PL CHICAGO, IL 60673 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $31 | $1K | 1.87% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO INC | 775 YARD ST STE 200 COLUMBUS, OH 43212 | METROPOLITAN LIFE INSURANCE COMPANY | — | $890 | $890 | 1.14% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC | 93033 NETWORK PL CHICAGO, IL 60673 | METROPOLITAN LIFE INSURANCE COMPANY | $153 | $581 | $734 | 0.94% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC | 93033 NETWORK PL CHICAGO, IL 60673 | VISION SERVICE PLAN | $756 | — | $756 | 4.08% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN, INC. | 93033 NETWORK PL CHICAGO, IL 60673 | VISION SERVICE PLAN | $942 | — | $942 | 5.09% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | BANC ONE DEPT 100485 PASADENA, CA 91189 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $35 | $35 | — |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $24 | $24 | — |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $3 | $3 | — |
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 | 117 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 119 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 174 | $1.5M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 176 | $78K |
| Vision(2 contracts) | VISION SERVICE PLAN | 99 | $37K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 116 | $107K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 116 | $107K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 116 | $107K |
| Prescription drug | BLUECROSS BLUESHIELD OF ILLINOIS | 174 | $1.5M |
| Other(3 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF ILLINOIS | 174 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 176 | — |
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.