| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY, LTD | 1750 EAST GOLF RD SCHAUMBURG, IL 60173 | PRINCIPAL LIFE INSURANCE COMPANY | $12K | $589 | $12K | 21.01% |
| ASSURANCE AGENCY LTD3 | 1750 EAST GOLF RD SCHAUMBURG, IL 60173 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $170 | $4K | 13.92% |
| REBECCA STERNBERG3 | 374 MILFORD RD DEERFIELD, IL 60015 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $103 | $1K | 5.72% |
| DAVID TODD WEINSTEIN3 Filed as: DAVID T WEINSTEIN | 601 W JACKSON BLVD, UNIT 912 CHICAGO, IL 60661 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $682 | $499 | $1K | 4.56% |
| MICHAEL BLOCK3 | 16619 S PINECREEK DR LOCKPORT, IL 60441 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $881 | $240 | $1K | 4.33% |
| JOSHUA T JONES3 | 25 GARFIELD LN STREAMWOOD, IL 60107 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | $28 | $44 | 0.17% |
| ASSURANCE AGENCY LTD3 | 1750 EAST GOLF ROAD OSAGE BEACH, IL 60173 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $982 | $3K | 20.77% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY, LTD | 1750 GOLF RD, STE 140 CHICAGO, IL 60173 | VISION SERVICE PLAN | $1K | — | $1K | 11.53% |
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 | 124 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 125 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 110 | $15K |
| Vision | VISION SERVICE PLAN | 96 | $11K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 181 | $85K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 181 | $59K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 181 | $59K |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 181 | $59K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 181 | — |
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.