| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 233 S WACKER DR STE 2000 CHICAGO, IL 60606 | BLUECROSS BLUESHIELD OF ILLINOIS | $31K | $2K | $33K | 4.26% |
| DREYFUS & BIRKE LTD3 | 340 MADISON AVE 21ST FLOOR NEW YORK, NY 10173 | BLUECROSS BLUESHIELD OF ILLINOIS | — | $3 | $3 | 0.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 233 S WACKER DR STE 2000 CHICAGO, IL 60606 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $2K | $6K | 5.05% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | STE 1100 425 N MARTINGALE RD SCHAUMBURG, IL 60173 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 11.29% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 11TH FL 425 N MARTINGALE RD SCHAUMBURG, IL 60173 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $641 | $641 | 1.25% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | STE 1100 425 MARTINGALE RD SCHAUMBURG, IL 60173 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 15.64% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 11TH FL 425 N MARTINGALE RD SCHAUMBURG, IL 60173 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $90 | $90 | 1.31% |
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 | 100 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 100 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 236 | $773K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 202 | $112K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 118 | $58K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 118 | $51K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 118 | $51K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 118 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 236 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.