| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INCENTISURE INC.3 | 6815 WEAVER RD., STE 200 ROCKFORD, IL 61114 | THE UNION LABOR LIFE INSURANCE COMPANY | $22K | — | $22K | 10.00% |
| INCENTISURE INC.3 Filed as: INCENTISURE INC | — | DELTA DENTAL OF ILLINOIS | $15K | — | $15K | 10.00% |
| INCENTISURE INC.3 Filed as: INCENTISURE INC | — | PROTEC INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| INCENTISURE INC. EIN 45-3171039 NONE | Consulting fees; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $42K |
| WIPFLI LLP EIN 39-0758449 NONE | Accounting (including auditing) Service code 10 | — | $14K |
| RISK & REGULATORY CONSULTING LLC EIN 45-4100320 NONE | Actuarial Service code 11 | — | $10K |
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 | 1,611 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 92 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,703 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF ILLINOIS | 186 | $146K |
| Vision | PROTEC INSURANCE COMPANY | 104 | $12K |
| Life insurance | THE UNION LABOR LIFE INSURANCE COMPANY | 2,454 | $217K |
| Other | THE UNION LABOR LIFE INSURANCE COMPANY | 2,454 | $217K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,454 | — |
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.