| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, INC. | UNKNOWN CHICAGO, IL 60606 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $121K | $12K | $133K | 3.25% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 1787 SENTRY PARKWAY WEST, SUITE 320 BLUE BELL, PA 19422 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $24K | $29K | $53K | 19.27% |
| PREPARE BENEFITS, LLC5 | 10524 MOSS PARK ROAD ORLANDO, FL 32832 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $10K | $10K | 3.52% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 1787 SENTRY PARKWAY WEST, SUITE 320 BLUEBELL, PA 19422 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $4K | 1.39% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | UNKNOWN CHICAGO, IL 60606 | DELTA DENTAL OF ILLINOIS | $18K | $0 | $18K | 8.18% |
| THE BOON INSURANCE AGENCY3 Filed as: BOON INSURANCE AGENCY, INC. | UNKNOWN CHICAGO, IL 60606 | DELTA DENTAL OF ILLINOIS | $0 | $9K | $9K | 4.36% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 725 RXR PLAZA EAST TOWER UNIONDALE, NY 11556 | UNITEDHEALTHCARE INSURANCE COMPANY | $4K | $0 | $4K | 9.91% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, INC. | UNKNOWN CHICAGO, IL 60606 | ALPHA DENTAL PROGRAMS, INC. | $1K | $0 | $1K | 4.57% |
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 | 581 | 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) | 581 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 685 | $4.1M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF ILLINOIS | 317 | $241K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 631 | $44K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 581 | $275K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 581 | $275K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 581 | $275K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ILLINOIS | 685 | $4.1M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 581 | $275K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 685 | — |
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.