| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 500 W MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $43 | $2K | 4.11% |
| LOCKTON COMPANIES, LLC3 | 444 W. 47TH STREET, SUITE 600 KANSAS CITY, MO 64112 | METROPOLITAN LIFE INSURANCE COMPANY | — | $368 | $368 | 1.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON PENNSYLVANIA, INC. | P.O. BOX 9102 PHILADELPHIA, PA 19178 | METROPOLITAN LIFE INSURANCE COMPANY | $223 | $136 | $359 | 0.97% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF ILLINOIS EIN 36-1236610 MEDICAL ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $442K |
| TOWERS WATSON PENNSYLVANIA, INC. EIN 23-1159360 BROKER | Insurance agents and brokers Service code 22 | — | $7K |
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 | 579 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 590 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE | 1,284 | $62K |
| Stop-loss / reinsurancereinsurance | BLUECROSS BLUESHIELD OF ILLINOIS | 829 | $477K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 330 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,284 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.