| 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 CHICAGO, IL 60606 | BLUECROSS BLUESHIELD OF ILLINOIS | $53K | $2K | $55K | 4.07% |
| HOME OFFICE TPA PAYS COMMISSION3 | 475 FALLBROOK BLVD LINCOLN, NE 68521 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $11K | — | $11K | 12.29% |
| 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 | 8.04% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $916 | — | $916 | 4.31% |
| 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 | — | $367 | $367 | 1.73% |
| 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 | 12.38% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $750 | — | $750 | 4.35% |
| 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 | — | $276 | $276 | 1.60% |
| 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 | — | $899 | $899 | 11.20% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 35371 NETWORK PLACE CHICAGO, IL 60673 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $201 | — | $201 | 2.50% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 35371 NETWORK PLACE CHICAGO, IL 60673 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $590 | — | $590 | 15.01% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $179 | — | $179 | 4.55% |
| 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 | — | $46 | $46 | 1.17% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 35371 NETWORK PLACE CHICAGO, IL 60673 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $220 | — | $220 | 8.45% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $111 | — | $111 | 4.26% |
| 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 | — | $47 | $47 | 1.80% |
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 | 130 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 132 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 186 | $1.4M |
| Dental | RELIANCE STANDARD LIFE INSURANCE COMPANY | 213 | $89K |
| Vision | RELIANCE STANDARD LIFE INSURANCE COMPANY | 213 | $89K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 120 | $11K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 120 | $21K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 120 | $17K |
| Prescription drug | BLUECROSS BLUESHIELD OF ILLINOIS | 186 | $1.4M |
| Other(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 120 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 213 | — |
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.