| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N. MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $80K | $2K | $82K | 3.76% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY LTD. | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 12.55% |
| MARSH & MCLENNAN AGENCY LLC3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 2.45% |
| ASSURANCE AGENCY LTD3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 8.35% |
| MARSH & MCLENNAN AGENCY LLC3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $767 | — | $767 | 1.65% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | UNITED OF OMAHA LIFE INSURANCE CO | $5K | — | $5K | 12.53% |
| MARSH & MCLENNAN AGENCY LLC3 | 20 N MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | UNITED OF OMAHA LIFE INSURANCE CO | $1K | — | $1K | 2.47% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N. MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | DELTA DENTAL OF ILLINOIS | $14K | — | $14K | 59.32% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N. MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | EYEMED | $2K | — | $2K | 10.03% |
| ASSURANCE AGENCY LTD3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 10.05% |
| MARSH & MCLENNAN AGENCY LLC3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $258 | — | $258 | 1.96% |
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 | 167 | 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) | 171 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 331 | $2.2M |
| Dental | DELTA DENTAL OF ILLINOIS | 158 | $23K |
| Vision | EYEMED | 352 | $17K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 167 | $13K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 162 | $46K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE CO | 162 | $41K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 167 | $62K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 352 | — |
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.