| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY, LTD | 1750 EAST GOLF ROAD ONE CENTURY CENTRE SCHAUMBURG, IL 60173 | BLUECROSS BLUESHIELD OF ILLINOIS | $80K | $2K | $82K | 3.74% |
| MAYEKAWA USA, INC.3 | 1850 JARVIS AVE ELK GROVE VILLAGE, IL 60007 | BLUECROSS BLUESHIELD OF ILLINOIS | — | $3 | $3 | 0.00% |
| ASSURANCE AGENCY LTD3 | 1750 E GOLF ROAD SCHAUMBURG, IL 60173 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $203 | $5K | 10.45% |
| ASSURANCE AGENCY LTD3 | 1750 E GOLF ROAD SCHAUMBURG, IL 60173 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | $144 | $6K | 15.40% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E GOLF RD SCHAUMBURG, IL 60173 | THE LINCOLN NATIONAL LIFE INSURANCE CO | $5K | $181 | $5K | 15.53% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY, LTD | 1750 E. GOLF ROAD SCHAUMBURG, IL 60173 | DELTA DENTAL OF ILLINOIS | $14K | — | $14K | 60.39% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E GOLF RD SCHAUMBURG, IL 60173 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 10.13% |
| ASSURANCE AGENCY LTD3 | 1750 E GOLF ROAD SCHAUMBURG, IL 60173 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $65 | $2K | 12.48% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY, LTD | 1750 E GOLF RD SCHAUMBURG, IL 60173 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $10 | $10 | 0.46% |
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 | 185 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 24 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 210 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 365 | $2.2M |
| Dental | DELTA DENTAL OF ILLINOIS | 169 | $24K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 370 | $18K |
| Life insurance(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE CO | 184 | $48K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 185 | $45K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 185 | $36K |
| Other(3 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE CO | 184 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 370 | — |
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.