| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VISTA NATIONAL INSURANCE GROUP INC3 Filed as: VISTA NATIONAL INSURANCE | 1301 W 22ND ST STE 600 OAK BROOK, IL 60523 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $30K | $30K | 3.09% |
| VISTA NATIONAL INSURANCE GROUP INC3 Filed as: VISTA NATIONAL INSURANCE GROUP | 1301 WEST 22ND STREET SUITE 600 OAK BROOK, IL 60523 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $15K | $3K | $18K | 17.44% |
| THE PIETSCH FINANCIAL GROUP IN3 | — | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $544 | — | $544 | 0.52% |
| VISTA NATIONAL INSURANCE GROUP INC3 Filed as: VISTA NATIONAL INSURANCE GROUP | 1301 W 22ND STREET STE 300 OAK BROOK, IL 60523 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 7.64% |
| VISTA NATIONAL INSURANCE GROUP INC3 Filed as: VISTA NATIONAL INSURANCE 819 | 1301 W 22ND ST STE 600 OAK BROOK, IL 60523 | COMPANION LIFE INSURANCE COMPANY DENTAL PLAN | $4K | — | $4K | 10.76% |
| VISTA NATIONAL INSURANCE GROUP INC3 Filed as: VISTA NATIONAL INSURANCE GROUP | 1301 W 22ND STREET STE 300 OAK BROOK, IL 60523 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 15.01% |
| VISTA NATIONAL INSURANCE GROUP INC3 Filed as: VISTA NATIONAL INSURANCE 819 | 1301 W 22ND ST STE 600 OAK BROOK, IL 60523 | TOTAL DENTAL ADMINISTRATORS HEALTH PLAN, INC. | $610 | — | $610 | 7.07% |
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 | 233 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 233 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 192 | $983K |
| Dental(2 contracts, 2 carriers) | COMPANION LIFE INSURANCE COMPANY DENTAL PLAN | 64 | $49K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 148 | $105K |
| Life insurance(4 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 233 | $216K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 148 | $105K |
| Long-term disability(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 233 | $206K |
| Other(3 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 233 | $215K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 233 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.