| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MESIROW INSURANCE SERVICES INC3 | 353 N CLARK ST STE 1100 CHICAGO, IL 60654 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $1K | $7K | 18.17% |
| MESIROW INSURANCE SERVICES INC3 | 353 N CLARK ST STE 1100 CHICAGO, IL 60654 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $1K | $7K | 18.54% |
| CAPTIVE RESOURCES INS SERVICES INC3 | 201 E COMMERCE DRIVE SCHAUMBURG, IL 60173 | AFLAC | $861 | — | $861 | 4.98% |
| DEBORAH A GUILBEAULT3 | 120 VALLEY VIEW ALGONQUIN, IL 60102 | AFLAC | $532 | $39 | $571 | 3.30% |
| ELIZABETH M GASPAROVIC3 | 1653 N BELMONT COURT ARLINGTON HEIGHTS, IL 60004 | AFLAC | $505 | — | $505 | 2.92% |
| SARAH CHIESA3 | 7838 W RASCHER AVE CHICAGEO, IL 60656 | AFLAC | $150 | $36 | $186 | 1.08% |
| GENE L NAUERT3 | 4505 BILLINGSGATE LANE WOODSTOCK, IL 60098 | AFLAC | $151 | — | $151 | 0.87% |
| KELLY V ZURZOLO3 | 9217 S IL RTE 31, STE 200 LAKE IN THE HILLS, IL 60156 | AFLAC | $143 | — | $143 | 0.83% |
| MICHELE M BRIGHT3 | 9217 S IL ROUTE 31 LK IN THE HLS, IL 60156 | AFLAC | $85 | — | $85 | 0.49% |
| MICHAEL E MCCARTHY3 | PO BOX 1047 DUNDEE, IL 60118 | AFLAC | $79 | — | $79 | 0.46% |
| CHAD L NELSON3 Filed as: CHAD NELSON | 490 EAST ROOSEVELE AVE STE 203 WEST CHICAGO, IL 60185 | AFLAC | $54 | $8 | $62 | 0.36% |
| DON J CONOYER3 | 303 HOGUE LN WYLIE, TX 75098 | AFLAC | $60 | — | $60 | 0.35% |
| SCALETTA INSURANCE AGENCY INC3 | 4552 N OTTAWA AVE NORRIDGE, IL 60706 | AFLAC | $41 | $7 | $48 | 0.28% |
| LISA M HELZING3 | 620 JILL COURT DES PLAINES, IL 60018 | AFLAC | $36 | — | $36 | 0.21% |
| KENNETH J HOFFMAN3 | N65 W13544 COBBLESTONE CT MENOMONEE FALLS, WI 53051 | AFLAC | $29 | — | $29 | 0.17% |
| DEAN ANAGNOPOULOS3 | 1108 S OAKWOOD DR MT PROSPECT, IL 60056 | AFLAC | $24 | — | $24 | 0.14% |
| MARK D BARBIER3 | 802 DEER TRAIL LN OAK BROOK, IL 60195 | AFLAC | $15 | $7 | $22 | 0.13% |
| TIMOTHY B ASBY3 Filed as: TIMOTHY BASBY | 9247 N MERIDIAN ST STE 205 INDIANAPOLIS, IN 46260 | AFLAC | $8 | $8 | $16 | 0.09% |
| GLEN T SCHWEIKERT3 | 2211 HIGHLAND SPRINGS PL LOUISVILLE, KY 40245 | AFLAC | $15 | — | $15 | 0.09% |
| MICHAEL S MOORE3 | 2630 E COUNTY ROAD 1300 CARTHAGE, IL 62321 | AFLAC | $15 | — | $15 | 0.09% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INS SVCS INC | 353 NORTH CLARK ST CHICAGO, IL 60654 | HM INSURANCE | $1K | — | $1K | 10.00% |
| MESIROW INSURANCE SERVICES INC3 | 353 N CLARK ST STE 1100 CHICAGO, IL 60654 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $863 | $183 | $1K | 18.18% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW FINANCIAL | 1 OAKBROOK TERRACE OAKBROOK TERRACE, IL 60181 | ACE AMERICAN INSURANCE COMPANY | $375 | — | $375 | 15.00% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW FINANCIAL | 1 OAKBROOK TERRACE OAKBROOK TERRACE, IL 60181 | ACE AMERICAN INSURANCE COMPANY | $285 | — | $285 | 15.00% |
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 | 152 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 155 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AFLAC | 24 | $17K |
| Vision | HM INSURANCE | 104 | $10K |
| Life insurance(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 152 | $60K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 152 | $41K |
| Other(4 contracts, 3 carriers) | AFLAC | 152 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 152 | — |
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.