| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $177 | $177 | 0.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MINNESOTA, INC. | 93076 NETWORK PLACE CHICAGO, IL 606731930 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $12K | — | $12K | 12.74% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | WILLIS OF ILLINOIS, INC. - INNOTECH 233 S WACKER DR STE 2000 CHICAGO, IL 60606 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 4.69% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | PO BOX 93076 CHICAGO, IL 60673 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $170 | $12 | $182 | 0.71% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | PO BOX 93076 CHICAGO, IL 60673 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $395 | $9 | $404 | 3.92% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | WILLIS OF ILLINOIS, INC. - INNOTECH 233 S WACKER DR STE 2000 CHICAGO, IL 60606 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $53 | — | $53 | 0.51% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | WILLIS OF ILLINOIS, INC. - INNOTECH 233 S WACKER DR STE 2000 CHICAGO, IL 60606 | FIRST UNUM LIFE INSURANCE COMPANY | $35 | — | $35 | 4.93% |
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 | 962 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 158 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,125 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 1,462 | $94K |
| Life insurance(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 981 | $760K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 981 | $734K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 981 | $734K |
| Other(4 contracts, 4 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 981 | $770K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,462 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.