| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STUMM INSURANCE LLC3 | 6601 N. AVONDALE AVENUE SUITE 201 CHICAGO, IL 60631 | BLUE CROSS AND BLUE SHIELD OF VERMONT | $30K | $0 | $30K | 2.91% |
| STUMM INSURANCE LLC3 | 6601 N. AVONDALE AVENUE SUITE 201 CHICAGO, IL 60631 | AMERITAS LIFE INSURANCE COMPANY | $9K | $0 | $9K | 10.00% |
| STUMM INSURANCE LLC3 | 6601 N. AVONDALE AVENUE SUITE 201 CHICAGO, IL 60631 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 10.00% |
| STUMM INSURANCE LLC3 | 6601 N. AVONDALE AVENUE SUITE 201 CHICAGO, IL 60631 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | $0 | $1K | 9.77% |
| STUMM INSURANCE LLC3 | 6601 N. AVONDALE AVENUE SUITE 201 CHICAGO, IL 60631 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 15.00% |
| STUMM INSURANCE LLC3 | 6601 N. AVONDALE AVENUE SUITE 201 CHICAGO, IL 60631 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $966 | $0 | $966 | 10.00% |
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 | 162 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 164 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF VERMONT | 177 | $1.0M |
| Dental | AMERITAS LIFE INSURANCE COMPANY | 246 | $85K |
| Vision(3 contracts, 3 carriers) | BLUE CROSS AND BLUE SHIELD OF VERMONT | 246 | $1.1M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 159 | $24K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 31 | $10K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 31 | $10K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF VERMONT | 177 | $1.0M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 159 | $24K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 246 | — |
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.