| 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 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $44K | $2K | $46K | 4.03% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 1800 RIVER DR MOLINE, IL 61265 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | $1K | $9K | 11.72% |
| BENSMAN ASSOCIATES LTD3 Filed as: BENSMAN ASSOC LTD | 2333 WAUKEGAN RD, STE 275 BANNOCKBURN, IL 60015 | HARTFORD LIFE AND ACCIDENT | $1K | — | $1K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 35371 NETWORK PLACE CHICAGO, IL 60673 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | — | $2K | 14.91% |
| GARRY LYNN JOHNSON3 | 3850 E BASELINE RD, STE 121 MESA, AZ 85206 | PRINCIPAL LIFE INSURANCE COMPANY | — | $253 | $253 | 1.99% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | 525 MARKET ST FL 34 SAN FRANCISCO, CA 94105 | PRINCIPAL LIFE INSURANCE COMPANY | — | $32 | $32 | 0.25% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC. | 35371 NETWORK PLACE CHICAGO, IL 60673 | VISION SERVICE PLAN | $851 | — | $851 | 6.89% |
| BENSMAN ASSOCIATES LTD3 | 2333 WAUKEGAN RD, STE 275 BANNOCKBURN, IL 60015 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
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 | 104 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 107 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 204 | $1.1M |
| Dental(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 98 | $89K |
| Vision | VISION SERVICE PLAN | 81 | $12K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 98 | $13K |
| Long-term disability(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 108 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 204 | — |
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.