| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC. | 1001 LAKE SIDE AVENUE CLEVELAND, OH 44114 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $18K | — | $18K | 2.48% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | 701 B STREET SAN DIEGO, CA 92101 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $12K | $12K | 1.60% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC. | 93245 NETWORK PLACE CHICAGO, IL 60673 | VISION SERVICE PLAN | $4K | — | $4K | 4.16% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | PO BOX 8299 PASADENA, CA 91109 | VISION SERVICE PLAN | $184 | — | $184 | 0.20% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC. | 775 YARD STREET SUITE 200 COLUMBUS, OH 43212 | METLIFE LEGAL PLANS | $4K | — | $4K | 9.31% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | METLIFE LEGAL PLANS | — | $619 | $619 | 1.32% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | PO BOX 8299 PASADENA, CA 91109 | METLIFE LEGAL PLANS | $396 | — | $396 | 0.85% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | 3600 N CAPITAL OF TEXAS HWY SUITE B-200 AUSTIN, TX 78746 | METLIFE LEGAL PLANS | — | $140 | $140 | 0.30% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC. | 93245 NETWORK PLACE CHICAGO, IL 60673 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $27 | $4K | 12.29% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICE | 101 PARK AVENUE 12TH FLOOR NEW YORK, NY 10016 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $105 | $105 | 0.33% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC. | 775 YARD ST SUITE 200 COLUMBUS, OH 43212 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $831 | — | $831 | 3.61% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $87 | — | $87 | 0.38% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | 101 PARK AVENUE 12TH FLOOR NEW YORK, NY 10178 | DELAWARE AMERICAN LIFE INSURANCE COMPANY | $225 | — | $225 | 7.50% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC. | 93076 NETWORK PLACE CHICAGO, IL 60673 | DELAWARE AMERICAN LIFE INSURANCE COMPANY | $225 | — | $225 | 7.50% |
| AON CONSULTING INC3 Filed as: AON CONSULTING INC. | 165 BROADWAY STE 3201 NEW YORK, NY 10006 | ACE AMERICAN INSURANCE COMPANY | $391 | — | $391 | 19.99% |
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 | 763 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 25 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 792 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 763 | $3K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 121 | $23K |
| Vision | VISION SERVICE PLAN | 484 | $94K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 667 | $729K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 667 | $729K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 667 | $729K |
| Other(4 contracts, 3 carriers) | METLIFE LEGAL PLANS | 763 | $81K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 763 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.