| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 233 S WACKER DR. CHICAGO, IL 60606 | BLUE CROSS AND BLUE SHIELD OF MINNESOTA AND BLUE PLUS | $73K | — | $73K | 3.23% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 8400 NORMANDALE LAKE BLVD STE 1700 BLOOMINGTON, MN 55437 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $15K | — | $15K | 9.24% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC. | LOCKBOX 93076 131 S. DEARBORN 6TH FLOOR CHICAGO, IL 60603 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $3K | — | $3K | 19.58% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 1 PPG PL STE 1000 PITTSBURGH, PA 15222 | METROPOLITAN LIFE INSURANCE COMPANY | $909 | $64 | $973 | 18.13% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO INC | 775 YARD ST STE 200 COLUMBUS, OH 43212 | METROPOLITAN LIFE INSURANCE COMPANY | — | $57 | $57 | 1.06% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | 200 LIBERTY STREET, 7TH FLOOR NEW YORK, NY 10281 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $755 | — | $755 | 24.99% |
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 | 246 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 247 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF MINNESOTA AND BLUE PLUS | 341 | $2.3M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 236 | $17K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 247 | $159K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 247 | $159K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF MINNESOTA AND BLUE PLUS | 341 | $2.3M |
| Other(4 contracts, 4 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 263 | $173K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 341 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.