| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JASON JARED3 | UNKNOWN CHAMPAIGN, IL 61821 | HEALTH ALLIANCE MEDICAL PLANS | $46K | $0 | $46K | 3.64% |
| ASSUREDPARTNERS3 Filed as: DIMOND BROS INSURANCE, LLC | PO BOX 1090 PARIS, IL 61944 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $0 | $8K | 11.25% |
| DAVID THOMAS KEENAN3 | UNKNOWN CHAMPAIGN, IL 61821 | ILLINOIS MUTUAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 11.44% |
| GARY WAYNE WARE3 | UNKNOWN CHAMPAIGN, IL 61821 | ILLINOIS MUTUAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 7.97% |
| MICHAEL PETERS & ASSOCIATES, INC.3 Filed as: MICHAEL PAUL PETERS | UNKNOWN CHAMPAIGN, IL 61821 | ILLINOIS MUTUAL LIFE INSURANCE COMPANY | $226 | $0 | $226 | 1.39% |
| LARRY CREWS3 | UNKNOWN CHAMPAIGN, IL 61821 | ILLINOIS MUTUAL LIFE INSURANCE COMPANY | $180 | $0 | $180 | 1.10% |
| NICHOLAS MEREDITH4 | 1404 NORTH FRANKLIN STREET DANVILLE, IL 61832 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $329 | $0 | $329 | 11.50% |
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 | 166 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 166 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH ALLIANCE MEDICAL PLANS | 155 | $1.3M |
| Dental | DELTA DENTAL OF ILLINOIS | 159 | $61K |
| Vision | VISION SERVICE PLAN | 108 | $14K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 166 | $67K |
| Short-term disability | ILLINOIS MUTUAL LIFE INSURANCE COMPANY | 65 | $16K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 166 | $67K |
| Prescription drug | HEALTH ALLIANCE MEDICAL PLANS | 155 | $1.3M |
| Other(2 contracts, 2 carriers) | ILLINOIS MUTUAL LIFE INSURANCE COMPANY | 65 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 166 | — |
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.