| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 20 NORTH MARTINGALE ROAD SUITE 100 SCHAUMBERG, IL 60173 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $46K | $4K | $50K | 24.08% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 20 NORTH MARTINGALE ROAD SUITE 100 SCHAUMBERG, IL 60173 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $31K | $3K | $33K | 23.90% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 20 N MARTINGALE RD SUITE 100 SCHAUMBURG, IL 60173 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 4.72% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 20 NORTH MARTINGALE ROAD SUITE 100 SCHAUMBERG, IL 60173 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 4.72% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 NORTH MARTINGALE ROAD SCHAUMBURG, IL 60173 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $8K | — | $8K | 10.42% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 20 NORTH MARTINGALE ROAD SUITE 100 SCHAUMBERG, IL 60173 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $13K | — | $13K | 18.51% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 20 N MARTINGALE RD SUITE 100 SCHAUMBURG, IL 60173 | FIRST UNUM LIFE INSURANCE COMPANY | $2K | $208 | $2K | 6.14% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 20 NORTH MARTINGALE ROAD SUITE 100 SCHAUMBERG, IL 60173 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 6.92% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 NORTH MARTINGALE ROAD SCHAUMBERG, IA 60173 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $152 | — | $152 | 7.84% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 20 NORTH MARTINGALE ROAD SUITE 100 SCHAUMBERG, IL 60173 | FIRST UNUM LIFE INSURANCE COMPANY | $60 | — | $60 | 7.22% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF ILLINOIS EIN 36-1236610 CONTRCT ADMTRTR | Contract Administrator; Direct payment from the plan Service code 13 | 300 E RANDOLPH ST CHICAGO, IL 60601 | $835K |
| HEALTHIESTYOU NONE | Contract Administrator; Other services Service code 13 | 5350 EAST HIGH STREET SUITE 350 PHOENIX, AZ 85054 | $61K |
| RSM US LLP EIN 42-0714325 NONE | Accounting (including auditing) Service code 10 | 3120 WELLONS BLVD NEW BERN, NC 28562 | $37K |
| DISCOVERY BENEFITS EIN 83-4136902 NONE | Accounting (including auditing) Service code 10 | 4321 20TH AVE S FARGO, ND 58103 | $10K |
| WELLS FARGO NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | 420 MONTGOMERY STREET SAN FARNCISCO, CA 94104 | $8K |
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 | 449 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 21 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 17 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 487 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision(2 contracts) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 645 | $77K |
| Life insurance(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 585 | $382K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 585 | $242K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 585 | $242K |
| Other(5 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 585 | $583K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 645 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.