| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TEDRICK 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 | — | $3K | $3K | 1.98% |
| TEDRICK EMPLOYEE BENEFITS INC3 | 1129 BROADWAY MT. VERNON, IL 62864 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | — | $11K | 15.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $5K | $5K | 6.82% |
| TEDRICK EMPLOYEE BENEFITS INC3 | 1129 BROADWAY MT. VERNON, IL 62864 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 15.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 6.83% |
| TEDRICK EMPLOYEE BENEFITS INC3 | 1129 BROADWAY MT. VERNON, IL 62864 | VISION SERVICE PLAN | $1K | — | $1K | 5.08% |
| TEDRICK EMPLOYEE BENEFITS INC3 | 1129 BROADWAY MT. VERNON, IL 62864 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 13.28% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $1K | $1K | 6.83% |
| TEDRICK EMPLOYEE BENEFITS INC3 | 1129 BROADWAY MT. VERNON, IL 62864 | UNUM INSURANCE COMPANY | $2K | — | $2K | 15.05% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM INSURANCE COMPANY | — | $694 | $694 | 6.11% |
| TEDRICK EMPLOYEE BENEFITS INC3 | 1129 BROADWAY MT. VERNON, IL 62864 | UNUM INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM INSURANCE COMPANY | — | $632 | $632 | 5.96% |
| TEDRICK EMPLOYEE BENEFITS INC3 | 1129 BROADWAY MT. VERNON, IL 62864 | UNUM INSURANCE COMPANY | $1K | — | $1K | 14.98% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM INSURANCE COMPANY | — | $451 | $451 | 6.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $165K |
| TEDRICK EMPLOYEE BENEFITS INC EIN 36-4178615 BROKER | Other commissions Service code 55 | 1129 BRODWAY P.O. BOX 983 MT. VERNON, IL 62864 | $49K |
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 | 281 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 282 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED STATE FIRE INSURANCE CO. | 33 | $289K |
| Dental | DELTA DENTAL OF ILLINOIS | 207 | $127K |
| Vision | VISION SERVICE PLAN | 188 | $25K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 298 | $49K |
| Short-term disability(2 contracts) | UNUM INSURANCE COMPANY | 55 | $19K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 298 | $15K |
| Stop-loss / reinsurancereinsurance | TOKIO MARINE | 220 | $344K |
| Other(7 contracts, 3 carriers) | UNITED STATE FIRE INSURANCE CO. | 298 | $438K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 298 | — |
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."
No prospect flags tripped on this filing.