| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE BJORK GROUP INC3 | — | BLUECROSS BLUESHIELD OF ILLINOIS | $32K | $394 | $32K | 2.82% |
| PHILLIPS BROS. INS. AGENCY, INC.3 Filed as: PHILLIPS BROS INS AGENCY INC | — | BLUECROSS BLUESHIELD OF ILLINOIS | $14K | — | $14K | 1.19% |
| THE BJORK GROUP INC3 | 1033 SKOKIE BOULEVARD SUITE 210 NORTHBROOK, IL 60062 | GUARDIAN | $7K | $3K | $10K | 6.97% |
| PHILLIPS BROS. INS. AGENCY, INC.3 Filed as: PHILLIPS BROS INS AGENCY INC | 2 N LASALLE STREET SUITE 1606 CHICAGO, IL 60602 | GUARDIAN | $2K | — | $2K | 1.72% |
| SAM POST3 | 17550 N PERIMETER DRIVE SUITE 450 SCOTTSDALE, AZ 85255 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | — |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATION INC | 3800 N CENTRAL AVENUE FLOOR 9 PHOENIX, AZ 85012 | METROPOLITAN LIFE INSURANCE COMPANY | $989 | — | $989 | — |
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 | 138 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 140 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 143 | $1.1M |
| Dental | GUARDIAN | 119 | $139K |
| Vision | GUARDIAN | 119 | $139K |
| Life insurance(2 contracts, 2 carriers) | GUARDIAN | 119 | $139K |
| Short-term disability(2 contracts, 2 carriers) | GUARDIAN | 119 | $139K |
| Long-term disability(2 contracts, 2 carriers) | GUARDIAN | 119 | $139K |
| Other(2 contracts, 2 carriers) | GUARDIAN | 119 | $139K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 143 | — |
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.