| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC | 35371 NETWORK PLACE CHICAGO, IL 60673 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $10K | $84K | $93K | 3.10% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC | 35371 NETWORK PLACE CHICAGO, IL 60673 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $733 | $733 | 0.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST | 35371 NETWORK PLACE CHICAGO, IL 60673 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $14K | — | $14K | 20.32% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 233 S WACKER DR STE 2000 WILLIS TOWER CHICAGO, IL 60606 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 3.42% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST | 35371 NETWORK PLACE CHICAGO, IL 60673 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | — | $7K | 20.21% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 233 S WACKER DR STE 2000 WILLIS TOWER CHICAGO, IL 60606 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 3.44% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST | 35371 NETWORK PLACE CHICAGO, IL 60673 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 20.44% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 233 S WACKER DR STE 2000 WILLIS TOWER CHICAGO, IL 60606 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $943 | — | $943 | 3.30% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 35371 NETWORK PLACE CHICAGO, IL 60673 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY LIFE INSURANCE COMPANY | $1K | — | $1K | 5.48% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC | 233 SOUTH WACKER DRIVE STE 2000 CHICAGO, IL 60606 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY LIFE INSURANCE COMPANY | $1K | — | $1K | 5.20% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST | 35371 NETWORK PLACE CHICAGO, IA 60673 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 12.72% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 233 S WACKER DR STE 2000 CHICAGO, IL 60606 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $254 | — | $254 | 2.28% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST | 35371 NETWORK PLACE CHICAGO, IL 60673 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 12.93% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 233 S WACKER DR STE 2000 WILLIS TOWER CHICAGO, IL 60606 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $197 | — | $197 | 2.06% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST | 35371 NETWORK PLACE CHICAGO, IL 60673 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $889 | — | $889 | 20.19% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS INC | 233 S WACKER DR STE 2000 WILLIS TOWER CHICAGO, IL 60606 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $152 | — | $152 | 3.45% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ILLINOIS, INC. | 233 S WACKER DRIVE, STE 1800 CHICAGO, IL 60606 | DELAWARE AMERICAN LIFE INSURANCE COMPANY | $225 | — | $225 | 15.00% |
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 | 310 | 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) | 310 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 244 | $3.0M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 244 | $3.0M |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY LIFE INSURANCE COMPANY | 408 | $27K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 310 | $71K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 310 | $29K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 310 | $37K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 244 | $3.0M |
| Other(4 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 310 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 408 | — |
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.