| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 111 N. CANAL ST, STE 550 CHICAGO, IL 60606 | PRINCIPAL LIFE INSURANCE CO | $11K | — | $11K | 18.43% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N. MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | COLONIAL LIFE AND ACCIDENT INS CO | $3K | — | $3K | 12.12% |
| R STERNBERG3 | 374 MILFORD RD DEERFIELD, IL 60015 | COLONIAL LIFE AND ACCIDENT INS CO | $716 | $25 | $741 | 3.15% |
| E BONNER3 | 974 ROSEFIELD LANE AURORA, IL 60504 | COLONIAL LIFE AND ACCIDENT INS CO | $135 | $140 | $275 | 1.17% |
| M BLOCK3 | 16619 S PINECREEK DRIVE LOCKPORT, IL 60441 | COLONIAL LIFE AND ACCIDENT INS CO | $198 | — | $198 | 0.84% |
| D T WEINSTEIN3 Filed as: D WEINSTEIN | 601 JACKSON BLVD, UNIT 912 CHICAGO, IL 60661 | COLONIAL LIFE AND ACCIDENT INS CO | $128 | — | $128 | 0.54% |
| D EARL3 | 289 REDWOOD AVENUE ELK GROVE, IL 60007 | COLONIAL LIFE AND ACCIDENT INS CO | $32 | $7 | $39 | 0.17% |
| J T JONES3 Filed as: J JONES | 25 GARFIELD LANE STREAMWOOD, IL 60107 | COLONIAL LIFE AND ACCIDENT INS CO | $10 | — | $10 | 0.04% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N. MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | GUARDIAN | $2K | $995 | $3K | 20.50% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N. MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | VISION SERVICE PLAN | $979 | — | $979 | 8.07% |
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 | 117 | 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) | 117 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN | 103 | $17K |
| Vision | VISION SERVICE PLAN | 111 | $12K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE CO | 174 | $83K |
| Short-term disability | PRINCIPAL LIFE INSURANCE CO | 174 | $60K |
| Long-term disability | PRINCIPAL LIFE INSURANCE CO | 174 | $60K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 174 | — |
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.