| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST,INC | 93033 NETWORK PLACE CHICAGO, IL 60673 | BLUE CROSS AND BLUE SHIELD OF ILLINOIS | $105K | $3K | $108K | 3.95% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 93033 NETWORK PLACE CHICAGO, IL 60673 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $64 | $2K | 2.24% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO, INC. | 775 YARD ST STE 200 COLUMBUS, OH 43212 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 2.16% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 400 N EXECUTIVE DR SUITE 300 BROOKFIELD, WI 53005 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $4K | $1K | $6K | 6.73% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $33 | $33 | 0.04% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 93033 NETWORK PL CHICAGO, IL 60673 | VISION SERVICE PLAN | $1K | — | $1K | 10.00% |
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 | 155 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 159 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF ILLINOIS | 229 | $2.7M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 200 | $89K |
| Vision | VISION SERVICE PLAN | 97 | $14K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 159 | $86K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 159 | $86K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 159 | $86K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 159 | $86K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 229 | — |
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.