| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFIT PLANNING SERVICES INC3 Filed as: BENEFIT PLANNING SERVICES | 929 S ALPINE ROAD SUITE 402 ROCKFORD, IL 61108 | DELTA DENTAL OF ILLINOIS | $14K | — | $14K | 10.00% |
| BENEFIT PLANNING SERVICES INC5 Filed as: BENEFIT PLANNING SERVICES INC. | 929 S ALPINE ROAD SUITE 402 ROCKFORD, IL 61108 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $11K | $17K | $27K | 20.13% |
| INCENTISURE INC.3 | 7431 E STATE ST #258 ROCKFORD, IL 61108 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $10K | $236 | $10K | 7.29% |
| BENEFIT PLANNING SERVICES INC3 Filed as: BENEFIT PLANNING SERVICES INC. | 929 S ALPINE ROAD SUITE 402 ROCKFORD, IL 61108 | PROTEC INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WIPFLI LLP EIN 39-0758449 NONE | Accounting (including auditing) Service code 10 | — | $13K |
| BENEFIT PLANNING SERVICES INC. EIN 13-4058106 PLAN ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Consulting fees Service code 15 | — | $12K |
| MIDWEST LABORERS PRIVATE HEALTH EXC EIN 47-3565712 NONE | Consulting fees; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $12K |
| INCENTISURE INC. EIN 45-3171039 NONE | Consulting fees; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $6K |
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 | 2,299 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 170 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,469 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF ILLINOIS | 187 | $140K |
| Vision | PROTEC INSURANCE COMPANY | 112 | $14K |
| Life insurance | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 767 | $135K |
| Other | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 767 | $135K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 767 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.