| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RANDY A BUTTS3 Filed as: RANDY BUTTS | 2806 E EMPIRE ST BLOOMINGTON, IL 617044223 | UNITEDHEALTHCARE INSURANCE COMPANY | $11K | $30K | $41K | 2.84% |
| CLEMENS & ASSOCIATES LIFE AGENCY3 Filed as: CLEMENS & ASSOCIATION LIFE AGENCY | PO BOX 5190 BLOOMINGTON, IL 617025190 | METROPOLITAN LIFE INSURANCE COMPANY | $45K | — | $45K | 12.93% |
| GROUP INSURANCE SERVICES INC3 | PO BOX 901 NAPERVILLE, IL 605660901 | METROPOLITAN LIFE INSURANCE COMPANY | $17K | $7K | $24K | 6.98% |
| CLEMENS & ASSOCIATES LIFE AGENCY3 Filed as: CLEMENS & ASSOCIATES | PO BOX 217 BLOOMINGTON, IL 61702 | HEALTH ALLIANCE MEDICAL PLANS | $450 | — | $450 | 0.81% |
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 | 222 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 225 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 208 | $1.5M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 703 | $347K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 703 | $347K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 703 | $347K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 703 | $347K |
| Prescription drug | HEALTH ALLIANCE MEDICAL PLANS | 48 | $56K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 703 | $347K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 703 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.