| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| 360 BENEFITS LLC3 | 20 N CLARK ST, SUITE 2825 CHICAGO, IL 606024109 | UNITED STATES FIERE INSURANCE COMPANY | $5K | — | $5K | 1.00% |
| 360 BENEFITS LLC3 | 20 N CLARK ST, SUITE 2825 CHICAGO, IL 60602 | VISION SERVICE PLAN | $2K | — | $2K | 3.55% |
| 360 BENEFITS LLC3 | 20 N CLARK ST, SUITE 2825 CHICAGO, IL 606024109 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 11.05% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 233 SOUTH WACKER DRIVE, SUITE 2000 CHICAGO, IL 606066400 | METROPOLITAN LIFE INSURANCE COMPANY | $80 | $288 | $368 | 2.20% |
| 360 BENEFITS LLC | 20 N CLARK ST, SUITE 2825 CHICAGO, IL 606024109 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 17.81% |
| 360 BENEFITS LLC | 20 N CLARK ST, SUITE 2825 CHICAGO, IL 606024109 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 27.52% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 233 SOUTH WACKER DRIVE, SUITE 2000 CHICAGO, IL 606066400 | BLUECROSS BLUESHIELD OF ILLINOIS | — | $5K | $5K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENEFIT ADMINISTRATIVE SYSTEMS, LLC EIN 36-4197088 ADMINISTRATIVE SERVICES | Plan Administrator Service code 14 | 17475 JOVANNA DRIVE HOMEWOOD, IL 60430 | $140K |
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 | 440 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 440 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 168 | $17K |
| Vision | VISION SERVICE PLAN | 401 | $54K |
| Stop-loss / reinsurancereinsurance | UNITED STATES FIERE INSURANCE COMPANY | 440 | $487K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 67 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 440 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.