| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 400 NORTH EXECUTIVE DRIVE BROOKFIELD, WI 53005 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $11K | — | $11K | 11.26% |
| FORSITE BENEFIT PARTNERS3 Filed as: FORSITE BENEFITS | 2300 RIVERSIDE DR STE 204 GREEN BAY, WI 54301 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 5.74% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | SERVICES PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 1.23% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | PO BOX 416672 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $114 | $114 | 0.12% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 400 NORTH EXECUTIVE DRIVE BROOKFIELD, WI 53005 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $3K | — | $3K | 4.13% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | PO BOX 416672 BOSTON, MA 02241 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | — | $228 | $228 | 0.36% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | SERVICES PO BOX 101162 PASADENA, CA 91189 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | — | $59 | $59 | 0.09% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 400 NORTH EXECUTIVE DRIVE BROOKFIELD, WI 53005 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 7.94% |
| FORSITE BENEFIT PARTNERS3 Filed as: FORSITE BENEFITS | 2300 RIVERSIDE DR STE 204 GREEN BAY, WI 54301 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 4.06% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | SERVICES PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $666 | $666 | 1.23% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | PO BOX 416672 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $114 | $114 | 0.21% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 400 NORTH EXECUTIVE DRIVE BROOKFIELD, WI 53005 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 8.01% |
| FORSITE BENEFIT PARTNERS3 Filed as: FORSITE BENEFITS | 2300 RIVERSIDE DR STE 204 GREEN BAY, WI 54301 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 3.99% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | SERVICES PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $470 | $470 | 1.24% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | PO BOX 416672 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $114 | $114 | 0.30% |
| FORSITE BENEFIT PARTNERS3 | 2300 RIVERSIDE DR STE 204 GREEN BAY, WI 543011900 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | — | $1K | 3.32% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 93033 NETWORK PL CHICAGO, IL 606730001 | METROPOLITAN LIFE INSURANCE COMPANY | $383 | $48 | $431 | 1.42% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO INC | 775 YARD ST STE 200 COLUMBUS, OH 432123891 | METROPOLITAN LIFE INSURANCE COMPANY | — | $107 | $107 | 0.35% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 400 NORTH EXECUTIVE DRIVE BROOKFIELD, WI 53005 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 6.67% |
| FORSITE BENEFIT PARTNERS3 Filed as: FORSITE BENEFITS | 2300 RIVERSIDE DR STE 204 GREEN BAY, WI 54301 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $944 | — | $944 | 3.33% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | PO BOX 416672 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $114 | $114 | 0.40% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | SERVICES PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $28 | $28 | 0.10% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 400 NORTH EXECUTIVE DRIVE BROOKFIELD, WI 53005 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $229 | — | $229 | 7.95% |
| FORSITE BENEFIT PARTNERS3 Filed as: FORSITE BENEFITS | 2300 RIVERSIDE DR STE 204 GREEN BAY, WI 54301 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $117 | — | $117 | 4.06% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHWEST INC | PO BOX 416672 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $114 | $114 | 3.96% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | SERVICES PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $36 | $36 | 1.25% |
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 | 1,009 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,013 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 370 | $30K |
| Life insurance(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,231 | $210K |
| Short-term disability(2 contracts, 2 carriers) | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 174 | $91K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 127 | $38K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,231 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,231 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.