| 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 | $50K | — | $50K | 3.87% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 35371 NETWORK PLACE CHICAGO, IL 60673 | BLUECROSS BLUESHIELD OF ILLINOIS | — | $2K | $2K | 0.17% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 35371 NETWORK PLACE CHICAGO, IL 60673 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 4.10% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 35371 NETWORK PLACE CHICAGO, IL 60673 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $977 | — | $977 | 2.50% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SVCS | 500 N AKARD STREET SUITE 4300 DALLAS, TX 75201 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $710 | $710 | 1.82% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 35371 NETWORK PLACE CHICAGO, IL 60673 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 10.60% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SVCS | 500 N AKARD STREET SUITE 4300 DALLAS, TX 75201 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $336 | $336 | 1.94% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 35371 NETWORK PLACE CHICAGO, IL 60673 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SVCS | 500 N AKARD STREET SUITE 4300 DALLAS, TX 75201 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $255 | $255 | 1.96% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS, INC. | 233 S WACKER DR STE 2000 WILLIS TOWER CHICAGO, IL 60606 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY LIFE INSURANCE COMPANY | $772 | — | $772 | 11.77% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC | 233 S WACKER DR STE 2000 WILLIS TOWER CHICAGO, IL 60606 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY LIFE INSURANCE COMPANY | $719 | — | $719 | 10.96% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 35371 NETWORK PLACE CHICAGO, IL 60673 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $340 | — | $340 | 15.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SVCS | 500 N AKARD STREET SUITE 4300 DALLAS, TX 75201 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $41 | $41 | 1.81% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 35371 NETWORK PLACE CHICAGO, IL 60673 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $241 | — | $241 | 10.99% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SVCS | 500 N AKARD STREET SUITE 4300 DALLAS, TX 75201 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $27 | $27 | 1.23% |
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 | 123 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 124 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 169 | $1.3M |
| Dental | RELIANCE STANDARD LIFE INSURANCE COMPANY | 215 | $78K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY LIFE INSURANCE COMPANY | 105 | $7K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 49 | $41K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 117 | $17K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 117 | $13K |
| Prescription drug | BLUECROSS BLUESHIELD OF ILLINOIS | 169 | $1.3M |
| Other(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 57 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 215 | — |
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.