| 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 | $23K | $2K | $25K | 21.75% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 20 NORTH MARTINGALE ROAD SUITE 100 SCHAUMBERG, IL 60173 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $18K | $2K | $19K | 21.75% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 20 NORTH MARTINGALE ROAD SUITE 100 SCHAUMBERG, IL 60173 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 15.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 20 N MARTINGALE RD SUITE 100 SCHAUMBURG, IL 60173 | FIRST UNUM LIFE INSURANCE COMPANY | $2K | $267 | $3K | 5.52% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 NORTH MARTINGALE ROAD SUITE 100 SCHAUMBURG, IL 60173 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $5K | — | $5K | 11.88% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 20 N MARTINGALE RD SUITE 100 SCHAUMBURG, IL 60173 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $76 | $2K | 6.29% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 20 NORTH MARTINGALE ROAD SUITE 100 SCHAUMBERG, IL 60173 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $317 | $7 | $324 | 2.24% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 NORTH MARTINGALE ROAD SUITE 100 SCHAUMBERG, IA 60173 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $174 | — | $174 | 15.72% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF ILLINOIS EIN 36-1236610 CONTRCT ADMTRTR | Direct payment from the plan; Contract Administrator Service code 13 | 300 E RANDOLPH ST CHICAGO, IL 60601 | $334K |
| RSM US LLP EIN 42-0714325 NONE | Accounting (including auditing) Service code 10 | 3120 WELLONS BLVD NEW BERN, NC 28562 | $28K |
| HEALTHIESTYOU NONE | Contract Administrator; Other services Service code 13 | 5350 EAST HIGH STREET SUITE 350 PHOENIX, AZ 85054 | $22K |
| WELLS FARGO NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | 420 MONTGOMERY STREET SAN FARNCISCO, CA 94104 | $8K |
| DISCOVERY BENEFITS EIN 83-4136902 NONE | Accounting (including auditing) Service code 10 | 4321 20TH AVE S FARGO, ND 58103 | $4K |
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 | 337 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 9 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 349 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision(2 contracts) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 487 | $42K |
| Life insurance(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 508 | $217K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 508 | $159K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 508 | $159K |
| Other(4 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 604 | $301K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 604 | — |
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.