| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VISTA NATIONAL INSURANCE GROUP INC3 | — | BLUECROSS BLUESHIELD OF ILLINOIS | $119K | $3K | $123K | 3.87% |
| VISTA NATIONAL INSURANCE GROUP INC3 Filed as: VISTA NATIONAL INS GRP INC | 1301 WEST 22ND STREET SUITE 600 OAK BROOK, IL 60523 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $17K | — | $17K | 12.33% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF ILLINOIS | 1301 WEST 22ND STREET SUITE 600 OAK BROOK, IL 60523 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 2.67% |
| VISTA NATIONAL INSURANCE GROUP INC3 Filed as: VISTA NATIONAL INS GRP INC | 1301 WEST 22ND STREET SUITE 600 OAK BROOK, IL 60523 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | — | $6K | 12.32% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF ILLINOIS | 1301 WEST 22ND STREET SUITE 600 OAK BROOK, IL 60523 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 2.68% |
| N-GAGE LLC3 | 1999 PINE CREST ROAD GREEN BAY, WI 54313 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 21.18% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF ILLINOIS | 1301 WEST 22ND STREET SUITE 600 OAK BROOK, IL 60523 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $1K | $6K | 17.76% |
| H E INSURANCE INC3 | — | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $46 | — | $46 | 0.14% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF ILLINOIS, INC | 1301 WEST 22ND STREET SUITE 600 OAK BROOK, IL 60523 | VISION SERVICE PLAN | $519 | — | $519 | 1.72% |
| VISTANATIONAL INSURANCE GROUP3 | 1301 WEST 22ND STREET SUITE 600 OAK BROOK, IL 60523 | VISION SERVICE PLAN | $170 | — | $170 | 0.56% |
| VISTA NATIONAL INSURANCE GROUP INC3 Filed as: VISTA NATIONAL INS GRP INC | 1301 WEST 22ND STREET SUITE 600 OAK BROOK, IL 60523 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 8.23% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF ILLINOIS | 1301 WEST 22ND STREET SUITE 600 OAK BROOK, IL 60523 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $419 | — | $419 | 1.77% |
| VISTA NATIONAL INSURANCE GROUP INC3 Filed as: VISTA NATIONAL INS GRP INC | 1301 WEST 22ND STREET SUITE 600 OAK BROOK, IL 60523 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 7.98% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF ILLINOIS | 1301 WEST 22ND STREET SUITE 600 OAK BROOK, IL 60523 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $440 | — | $440 | 2.02% |
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 | 400 | 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) | 401 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 598 | $3.2M |
| Dental | BLUECROSS BLUESHIELD OF ILLINOIS | 598 | $3.2M |
| Vision | VISION SERVICE PLAN | 280 | $30K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 400 | $45K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 400 | $138K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 400 | $50K |
| Other(3 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 400 | $78K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 598 | — |
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.