| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 233 S WACKER DR CHICAGO, IL 60606 | BLUECROSS BLUESHIELD OF ILLINOIS | $181K | $7K | $188K | 2.28% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC | 93033 NETWORK PL CHICAGO, IL 60673 | METROPOLITAN LIFE INSURANCE COMPANY | — | $7K | $7K | 1.54% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WI, INC | PO BOX 1650 MILWAUKEE, WI 53201 | RELIASTAR LIFE INSURANCE COMPANY | $8K | — | $8K | 1.98% |
| JEAN PIERRE B BIAGUI4 | 5626 W VLIET ST APT 1 MILWAUKEE, WI 53208 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $870 | — | $870 | 7.94% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 233 S WACKER DR 20TH FL CHICAGO, IL 60606 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $647 | — | $647 | 5.91% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC | 400 N EXECUTIVE DR STE 300 BROOKFIELD, WI 53005 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $334 | — | $334 | 3.05% |
| RHONDA S UNSELL INC4 | 6525 GUNPARK DRIVE STE 370-152 BOULDER, CO 80301 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $127 | — | $127 | 1.16% |
| LINDA F JACKSON4 | 7800 W LISBON AVE MILWAUKEE, WI 53222 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $26 | — | $26 | 0.24% |
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 | 709 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 28 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 740 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 1,452 | $8.2M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,915 | $428K |
| Vision | VISION SERVICE PLAN | 524 | $54K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 790 | $427K |
| Short-term disability | RELIASTAR LIFE INSURANCE COMPANY | 790 | $427K |
| Long-term disability | RELIASTAR LIFE INSURANCE COMPANY | 790 | $427K |
| Other(3 contracts, 3 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 790 | $441K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,915 | — |
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.