| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | BLUECROSS BLUESHIELD OF ILLINOIS | $0 | $2K | $2K | 0.11% |
| ASSURANCE AGENCY LTD3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $11K | $0 | $11K | 8.16% |
| MARSH & MCLENNAN AGENCY LLC3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | $0 | $2K | 1.73% |
| MARSH & MCLENNAN AGENCY LLC3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $510 | $3K | 12.87% |
| ASSURANCE AGENCY LTD3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $991 | $0 | $991 | 4.39% |
| MARSH & MCLENNAN AGENCY LLC3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | HM LIFE INSURANCE COMPANY | $2K | $0 | $2K | 10.00% |
| JENNON M CARUTH3 | 7825 WASHINGTON AVE S STE 710 MINNEAPOLIS, MN 55439 | HARTFORD LIFE AND ACCIDENT | $700 | $0 | $700 | 18.21% |
| MARSH & MCLENNAN AGENCY LLC3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | HARTFORD LIFE AND ACCIDENT | $300 | $0 | $300 | 7.80% |
| WEBTPA EMPLOYER SERVICES LLC3 | 8500 FREEPORT PKWY SOUTH IRVING, TX 75063 | HARTFORD LIFE AND ACCIDENT | $0 | $231 | $231 | 6.01% |
| MARSH & MCLENNAN AGENCY LLC3 | 100 FRONT ST., STE. 800 WORCESTER, MA 01608 | HARTFORD LIFE AND ACCIDENT | $0 | $41 | $41 | 1.07% |
| MARSH & MCLENNAN AGENCY LLC3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $239 | $46 | $285 | 11.52% |
| ASSURANCE AGENCY LTD3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $132 | $0 | $132 | 5.34% |
| MARSH & MCLENNAN AGENCY LLC3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $119 | $22 | $141 | 12.50% |
| ASSURANCE AGENCY LTD3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $50 | $0 | $50 | 4.43% |
| MARSH & MCLENNAN AGENCY LLC3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $65 | $12 | $77 | 7.37% |
| ASSURANCE AGENCY LTD3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $40 | $0 | $40 | 3.83% |
| PECK JOHN LESLIE3 | 2727 ULMERTON RD., SUITE 230 CLEARWATER, FL 33762 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $14 | $0 | $14 | 1.40% |
| MARSH & MCLENNAN AGENCY LLC3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $11 | $2 | $13 | 7.78% |
| ASSURANCE AGENCY LTD3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6 | $0 | $6 | 3.59% |
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 | 165 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 169 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 318 | $1.7M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 189 | $134K |
| Vision | HM LIFE INSURANCE COMPANY | 185 | $16K |
| Life insurance(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 165 | $5K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 165 | $23K |
| Other(4 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 165 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 318 | — |
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.