| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | METROPOLITAN LIFE INSURANCE COMPANY | $22K | $4K | $26K | 10.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $12K | $908 | $13K | 10.08% |
| DEBRA POCZATKO3 Filed as: DEBRA RENEE BARCH | 14466 SOUTH ELIZABETH LANE HOMER GLEN, IL 60491 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9K | $1K | $10K | 7.52% |
| HENRY J SAMAAN3 Filed as: HENRY JACOB SAMAAN | 19W152 21ST PLACE LOMBARD, IL 60148 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8K | $2K | $9K | 7.25% |
| GERALD A GREENEN3 Filed as: GERALD A. GREENEN | 472 ROUTE 47, SUITE F-102 SUGAR GROVE, IL 60554 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $2K | $6K | 4.41% |
| MONICA L LEIVA3 Filed as: MONICA L. LEIVA | 556 NORTH ARTESIAN AVENUE CHICAGO, IL 60612 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $360 | $0 | $360 | 0.28% |
| ANTHONY VESTAL3 | 8437 STARLIGHT LOOP PARRISH, FL 34219 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $54 | $0 | $54 | 0.04% |
| YESENIA A SANCHEZ3 Filed as: YESENIA A. HERNANDEZ | 6715 SOUTH KEELER AVENUE CHICAGO, IL 60629 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6 | $0 | $6 | 0.00% |
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 | 202 | 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) | 202 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 474 | $257K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 474 | $257K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 474 | $257K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 105 | $130K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 474 | $257K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 474 | $387K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 474 | — |
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.