| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC. | 400 N. EXECUTIVE DRIVE SUITE 300 BROOKFIELD, WI 53005 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $63K | — | $63K | 2.97% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC. | 93033 NETWORK PLACE CHICAGO, IL 60673 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $953 | $2K | 1.64% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC. | 400 N EXECUTIVE DR SUITE 300 BROOKFIELD, WI 53005 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 5.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA INC | C/O WILLIS SAN FRANCISCO LOCKBOX LOCKBOX 100485 BANC ONE DEPT 100485 PASADENA, CA 91189 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $1K | $1K | 1.21% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $79 | $79 | 0.07% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN, INC. | 93033 NETWORK PL CHICAGO, IL 60673 | VISION SERVICE PLAN | $2K | — | $2K | 9.37% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN, INC. | C/O JP MORGAN CHASE 93033 NETWORK PLACE CHICAGO, IL 60673 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE CO. | $246 | $32 | $278 | 10.94% |
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 | 218 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 222 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 338 | $2.1M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 331 | $133K |
| Vision | VISION SERVICE PLAN | 161 | $24K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 225 | $116K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 225 | $116K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 225 | $116K |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 225 | $125K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 338 | — |
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.