| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TEDERICK EMPLOYEE BENEFITS INC3 | 1129 BROADWAY MT. VERNON, IL 62864 | DELTA DENTAL OF ILLINOIS | $9K | — | $9K | 7.41% |
| BAUGHMAN GROUP3 Filed as: BAUGHMAN GROUP INC-GA | — | DELTA DENTAL OF ILLINOIS | — | $2K | $2K | 1.98% |
| TEDRICK EMPLOYEE BENEFITS INC3 | 1129 BROADWAY MT. VERNON, IL 62864 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 15.33% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST. MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $6K | $6K | 9.00% |
| TEDRICK EMPLOYEE BENEFITS INC3 | 1129 BROADWAY MT. VERNON, IL 62864 | UNUM LIFE INSRUANCE COMPANY OF AMERICA | $5K | — | $5K | 15.69% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST. MORRIS, IL 60450 | UNUM LIFE INSRUANCE COMPANY OF AMERICA | — | $3K | $3K | 9.00% |
| TEDRICK EMPLOYEE BENEFITS INC3 | 1129 BROADWAY MT. VERNON, IL 62864 | VISION SERVICE PLAN | $1K | — | $1K | 5.46% |
| TEDRICK EMPLOYEE BENEFITS INC3 | 1129 BROADWAY MT. VERNON, IL 62864 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 16.29% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $1K | $1K | 9.00% |
| TEDRICK EMPLOYEE BENEFITS INC3 | 1129 BROADWAY MT. VERNON, IL 62864 | UNUM INSURANCE COMPANY | $2K | — | $2K | 13.63% |
| GIS BENEFITS INC Filed as: GIS BENEFITS | 422 WAUPONSEE ST. MORRIS, IL 60450 | UNUM INSURANCE COMPANY | — | $502 | $502 | 4.52% |
| TEDRICK EMPLOYEE BENEFITS INC3 Filed as: TEDRICK EMPLOYEE BENEFITS INC. | 1129 BROADWAY MT. VERNON, IL 62864 | UNUM INSURANCE COMPANY | $1K | — | $1K | 13.50% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST. MORRIS, IL 60450 | UNUM INSURANCE COMPANY | — | $381 | $381 | 4.50% |
| TEDRICK EMPLOYEE BENEFITS INC3 | 1129 BROADWAY MT. VERNON, IL 62864 | UNUM INSURANCE COMPANY | $832 | — | $832 | 13.66% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST. MORRIS, IL 60450 | UNUM INSURANCE COMPANY | — | $277 | $277 | 4.55% |
| TEDRICK EMPLOYEE BENEFITS INC3 | 1129 BROADWAY MT. VERNON, IL 62864 | HARTFORD LIFE AND ACCIDENT | -$6 | $0 | -$6 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $172K |
| TEDRICK EMPLOYEE BENEFITS INC. EIN 36-4178615 BROKER | Other commissions Service code 55 | 1129 BROADWAY P.O. BOX 983 MOUNT VERNON, IL 62864 | $56K |
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 | 276 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 277 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED STATES FIRE INSURANCE CO. | 42 | $28K |
| Dental | DELTA DENTAL OF ILLINOIS | 203 | $123K |
| Vision | VISION SERVICE PLAN | 179 | $21K |
| Life insurance(3 contracts, 3 carriers) | UNUM LIFE INSRUANCE COMPANY OF AMERICA | 284 | $42K |
| Short-term disability(2 contracts) | UNUM INSURANCE COMPANY | 54 | $17K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 284 | $13K |
| Stop-loss / reinsurancereinsurance | TOKIO MARINE | 189 | $338K |
| Other(8 contracts, 5 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 284 | $157K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 284 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.