| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| S J BENEFITS GROUP INC3 Filed as: S J BENEFITS GROUP | 2200 S MAIN STREET SUITE 100 LOMARD, IL 60148 | BLUECROSS BLUESHIELD | $65K | $3K | $68K | 1.33% |
| S J BENEFITS GROUP INC3 Filed as: S J BENEFITS GROUP | 2200 S MAIN STREET SUITE 100 LOMBARD, IL 60148 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $25K | — | $25K | 13.49% |
| S J BENEFITS GROUP INC3 | 2200 S MAIN STREET SUITE 100 LOMBARD, IL 60148 | VISION SERVICE PLAN | $4K | — | $4K | 2.92% |
| S J BENEFITS GROUP INC3 Filed as: SJ BENEFITS GROUP INC | 2200 S MAIN STREET SUITE 100 LOMBARD, IL 60148 | FOUR EVER LIFE INS CO | $5K | $2K | $7K | 12.00% |
| S J BENEFITS GROUP DBA CORMAC BEN3 | 2200 S MAIN STREET SUITE 100 LOMBARD, IL 60148 | DELTA DENTAL OF ILLINOIS | $34K | — | $34K | 59.48% |
| S J BENEFITS GROUP INC3 Filed as: S J BENEFITS GROUP | 2200 S MAIN STREET SUITE 100 LOMBARD, IL 60148 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 13.67% |
| S J BENEFITS GROUP INC3 | 2200 S MAIN STREET SUITE 100 LOMBARD, IL 60148 | FOUR EVER LIFE INS CO | $800 | — | $800 | 14.99% |
| S J BENEFITS GROUP DBA CORMAC BEN3 Filed as: S J BENEFITS GROUP DBA COR | 2200 S MAIN STREET SUITE 100 LOMBARD, IL 60148 | CIGNA GROUP INSURANCE | $150 | — | $150 | 15.00% |
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 | 452 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 456 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUECROSS BLUESHIELD | 1,227 | $5.2M |
| Dental | DELTA DENTAL OF ILLINOIS | 449 | $57K |
| Vision | VISION SERVICE PLAN | 442 | $142K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 451 | $182K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 451 | $182K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 452 | $236K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,227 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.