| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RANDY A BUTTS3 Filed as: RANDY BUTTS | 2806 E EMPIRE ST BLOOMINGTON, IL 61704 | UNITEDHEALTHCARE INSURANCE COMPANY | $45K | $1 | $45K | 2.99% |
| CLEMENS & ASSOCIATES LIFE AGENCY3 Filed as: CLEMENS & ASSOCIATION LIFE AGENCY | PO BOX 5190 BLOOMINGTON, IL 617025190 | METROPOLITAN LIFE INSURANCE COMPANY | $11K | — | $11K | 16.85% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $1K | $6K | 8.84% |
| GROUP INSURANCE SERVICES INC3 | PO BOX 901 NAPERVILLE, IL 605660901 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $542 | $542 | 0.84% |
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 | 243 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 244 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 314 | $1.5M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 293 | $64K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 293 | $64K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 293 | $64K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 293 | $64K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 293 | $64K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 314 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.