| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 2030 FALLING WATERS ROAD, SUITE 290 KNOXVILLE, TN 37922 | BLUE CROSS AND BLUE SHIELD OF ILLINOIS | $125K | $0 | $125K | 3.12% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | BLUE CROSS AND BLUE SHIELD OF ILLINOIS | $28K | $0 | $28K | 0.69% |
| ALLIANT INSURANCE SERVICES, INC.3 | 2030 FALLING WATERS ROAD, SUITE 290 KNOXVILLE, TN 37922 | METROPOLITAN LIFE INSURANCE COMPANY | $13K | $111 | $13K | 4.10% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DRIVE URBANDALE, IA 50323 | METROPOLITAN LIFE INSURANCE COMPANY | $11K | $0 | $11K | 3.64% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $0 | $4K | 1.28% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC. | 225 WIRELESS BOULEVARD, SUITE 200 HAUPPAUGE, NY 11788 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $17 | $4K | 1.27% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 1615 MURRAY CANYON ROAD, SUITE 1050 SAN DIEGO, CA 92108 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 0.49% |
| BENEFIT EXCHANGES ALLIANCE, INC.3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $774 | $774 | 0.25% |
| ALLIANT INSURANCE SERVICES, INC.3 | 5444 WESTHEIMER ROAD, SUITE 900 HOUSTON, TX 77056 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $20 | $20 | 0.01% |
| ALLIANT INSURANCE SERVICES, INC.3 | 800 GESSNER ROAD, SUITE 300 HOUSTON, TX 77024 | DEARBORN LIFE INSURANCE COMPANY | $39K | $0 | $39K | 14.51% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 100 OTTAWA AVENUE SW GRAN RAPIDS, MI 49503 | DEARBORN LIFE INSURANCE COMPANY | $4K | $0 | $4K | 1.58% |
| ADSH INVESTMENTS3 Filed as: ADSH INVESTMENTS II, INC. | 23716 BIRTCHER DRIVE LAKE FOREST, IL 92630 | DEARBORN LIFE INSURANCE COMPANY | -$2K | $0 | -$2K | -0.59% |
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 | 1,000 | 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) | 1,000 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF ILLINOIS | 501 | $4.0M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 830 | $310K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 830 | $310K |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 628 | $265K |
| Short-term disability | DEARBORN LIFE INSURANCE COMPANY | 628 | $265K |
| Long-term disability | DEARBORN LIFE INSURANCE COMPANY | 628 | $265K |
| Other(2 contracts, 2 carriers) | DEARBORN LIFE INSURANCE COMPANY | 1,000 | $274K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,000 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.