| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD ROLLING MEADOWS, IL 60008 | BLUE CROSS AND BLUE SHIELD OF ILLINOIS | $0 | $8K | $8K | 0.13% |
| REMPREX, LLC3 | 4343 COMMERCE COURT SUITE 300 LISLE, IL 60532 | BLUE CROSS AND BLUE SHIELD OF ILLINOIS | $0 | $2 | $2 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | DEARBORN LIFE INSURANCE COMPANY | $17K | $3K | $20K | 6.65% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM AND BUTLER INS SERVICES | 800 MAIN STREET DUBUQUE, IA 52001 | DEARBORN LIFE INSURANCE COMPANY | $2K | — | $2K | 0.68% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC GBS | FINANCE 333 EAST OSBORN ROAD PHOENIX, AZ 85012 | AETNA LIFE INSURANCE CO. | $28K | — | $28K | 25.49% |
| ACCRETIVE ENROLLMENT SERVICES LLC3 | 13750 SAN PEDRO AVE STE 550 SAN ANTONIO, TX 78232 | AETNA LIFE INSURANCE CO. | $18K | — | $18K | 16.42% |
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 | 333 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 346 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF ILLINOIS | 765 | $6.4M |
| Dental | BLUE CROSS AND BLUE SHIELD OF ILLINOIS | 765 | $6.4M |
| Vision | DEARBORN LIFE INSURANCE COMPANY | 451 | $300K |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 451 | $300K |
| Short-term disability | DEARBORN LIFE INSURANCE COMPANY | 451 | $300K |
| Long-term disability | DEARBORN LIFE INSURANCE COMPANY | 451 | $300K |
| Other(2 contracts, 2 carriers) | DEARBORN LIFE INSURANCE COMPANY | 451 | $409K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 765 | — |
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.