| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 400 N EXECUTIVE DRIVE SUITE 300 BROOKFIELD, WI 53005 | BLUE CARE NETWORK OF MICHIGAN | $3K | — | $3K | 1.37% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC. | 233 S WACKER DR STE 2000 CHICAGO, IL 60606 | BLUE CROSS AND BLUE SHIELD OF ILLINOIS | $4K | $200 | $4K | 2.97% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $552 | $552 | 1.48% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC | 400 NORTH EXECUTIVE DRIVE SUITE 300 BROOKFIELD, WI 53005 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 7.84% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $452 | $452 | 1.28% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 400 NORTH EXECUTIVE DRIVE SUITE 300 BROOKFIELD, WI 53005 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 11.14% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 SUITE 300 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $426 | $426 | 1.31% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST | 122 EAST COLLEGE AVENUE SUITE 201 APPLETON, WI 54911 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $650 | — | $650 | 12.26% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST | 233 SOUTH WACKER DR #2000 CHICAGO, IL 60606 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $100 | $100 | 1.89% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS - SEE ATTACHMENT | 600 COLLEGE AVE PEWAUKEE, WI 53072 | NORTHWESTERN MUTUAL | $632 | $147 | $779 | 18.09% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC | 111 E KILBOURN AVE STE 1850 MILWAUKEE, WI 53202 | SUN LIFE ASSURANCE COMPANY OF CANADA | $413 | — | $413 | 9.86% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 525 MARKET ST SUITE 3400 SAN FRANCISCO, CA 94105 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $43 | $43 | 1.03% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 400 NORTH EXECUTIVE DRIVE SUITE 300 BROOKFIELD, WI 53005 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $527 | — | $527 | 15.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 SUITE 300 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $12 | $12 | 0.34% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 525 MARKET ST SUITE 3400 SAN FRANCISCO, CA 94105 | SUN LIFE ASSURANCE COMPANY OF CANADA | $215 | — | $215 | 12.02% |
| WMC SERVICE CORPORATION3 | 2 BUTTONWOOD CT MADISON, WI 53718 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $215 | $215 | 12.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 525 MARKET ST SUITE 3400 SAN FRANCISCO, CA 94105 | SUN LIFE ASSURANCE COMPANY OF CANADA | $188 | — | $188 | 12.96% |
| WMC SERVICE CORPORATION3 | 2 BUTTONWOOD CT MADISON, WI 53718 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $188 | $188 | 12.96% |
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 | 328 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 328 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 13 | $321K |
| Life insurance(5 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 328 | $81K |
| Short-term disability(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 17 | $14K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 328 | $33K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 13 | $321K |
| Other(4 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 328 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 328 | — |
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."
No prospect flags tripped on this filing.