| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | — | BLUECROSS BLUESHIELD OF ILLINIOIS | $38K | — | $38K | 1.74% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES, INC. | ONE OAKBROOK TERRACE SUITE 500 OAKBROOK TERRACE, IL 60181 | BLUECROSS BLUESHIELD OF ILLINIOIS | $30K | — | $30K | 1.38% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES | 353 NORTH CLARK STREET CHICAGO, IA 60654 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $563 | $3K | 7.42% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERICES INC | 21ST FLOOR TWO PIERCE PLACE ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 5.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $299 | $299 | 0.67% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 1111 SUPERIOR AVE SUITE 1510 CLEVELAND, OH 44114 | STARMOUNT LIFE INSURANCE COMPANY | $2K | — | $2K | 4.38% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES | ONE OAKBROOK TERRACE OAKBROOK TERRACE, IL 60181 | STARMOUNT LIFE INSURANCE COMPANY | $2K | — | $2K | 4.37% |
| NORTHWEST WORKSITE MARKETING CORP3 | 1910 INDIANWOOD CIRCLE MAUMEE, OH 43537 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9K | $2K | $11K | 40.35% |
| DAVID TODD WEINSTEIN3 | 601 WEST JACKSON BOULEVARD UNIT 912 CHICAGO, IL 60661 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $375 | $4K | 16.26% |
| MESIROW INSURANCE SERVICES INC3 | 350 NORTH CLARK STREET CHICAGO, IL 60610 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 12.14% |
| JOSHUA T JONES3 | 25 GARFIELD LANE STREAMWOOD, IL 60107 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $650 | $888 | $2K | 5.64% |
| SHERRIE LYNN BUCHANAN3 | 815 SAVANNAH DRIVE COLUMBUS, OH 43228 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $217 | $1K | 4.49% |
| DIANA RAUCH3 | 2914 WEST CASE ROAD DUBLIN, OH 43017 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $940 | $106 | $1K | 3.83% |
| REBECCA STERNBERG3 | 374 MILFORD ROAD DEERFIELD, IL 60015 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $673 | $32 | $705 | 2.58% |
| MARK CHRISTOPHER MOTZ3 | 55 EPERNAY AVENUE PATASKALA, OH 43062 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $591 | $112 | $703 | 2.58% |
| PIPES INSURANCE SERVICE LTD3 Filed as: PIPES INSURANCE SERVICE | 442 WEST HIGH AVENUE NEW PHILADELPHIA, OH 44663 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $306 | — | $306 | 1.12% |
| JENNIFER LOEFFLER3 | 4455 MASON ROAD CANAL WINCHESTER, OH 43110 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $46 | $90 | $136 | 0.50% |
| LISA R CANFIELD3 | 324 STRAW COURT PATASKALA, OH 43062 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $46 | $32 | $78 | 0.29% |
| DAN YAARY3 | 1910 INDIAN WOOD CIRCLE MAUMEE, OH 43537 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $56 | — | $56 | 0.21% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES | 353 NORTH CLARK STREET CHICAGO, IL 60654 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $780 | $182 | $962 | 6.93% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 21ST FLOOR TWO PIERCE PLACE ITASCA, IA 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $721 | — | $721 | 5.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 W GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $90 | $90 | 0.65% |
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 | 174 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 174 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINIOIS | 444 | $2.2M |
| Dental(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF ILLINIOIS | 444 | $2.2M |
| Vision(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF ILLINIOIS | 444 | $2.2M |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 163 | $44K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 163 | $44K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 163 | $86K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 444 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.