| 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 STE 2000 WILLIS TOWER CHICAGO, IL 60606 | BLUECROSS BLUESHIELD OF ILLINOIS | $64K | — | $64K | 3.83% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 233 S WACKER DR STE 2000 WILLIS TOWER CHICAGO, IL 60606 | BLUECROSS BLUESHIELD OF ILLINOIS | — | $4K | $4K | 0.22% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 233 S WACKER DR STE 1850 WILLIS TOWER CHICAGO, IL 60606 | DEARBORN LIFE INSURANCE COMPANY | $3K | — | $3K | 3.10% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC | 775 YARD ST STE 200 COLUMBUS, OH 43212 | DEARBORN LIFE INSURANCE COMPANY | $265 | — | $265 | 0.24% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC | 233 S WACKER DR STE 2000 WILLIS TOWER CHICAGO, IL 60606 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $1K | — | $1K | 8.22% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 233 S WACKER DR STE 2000 WILLIS TOWER CHICAGO, IL 60606 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $608 | — | $608 | 3.43% |
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 | 161 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 10 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 177 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 387 | $1.7M |
| Dental | DELTA DENTAL OF ILLINOIS | 171 | $150K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 340 | $18K |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 162 | $110K |
| Short-term disability | DEARBORN LIFE INSURANCE COMPANY | 162 | $110K |
| Long-term disability | DEARBORN LIFE INSURANCE COMPANY | 162 | $110K |
| Prescription drug | BLUECROSS BLUESHIELD OF ILLINOIS | 387 | $1.7M |
| Other | DEARBORN LIFE INSURANCE COMPANY | 162 | $110K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 387 | — |
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.