| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHRISTOPHER A. BUSSEY3 | 858 NORTH FRANKLIN STREET, UNIT 204 CHICAGO, IL 60610 | STANDARD INSURANCE COMPANY | $4K | $0 | $4K | 0.57% |
| DANNY S. DONLEY3 | 1013 MALEVENTUM SPRING HILL, TN 37174 | STANDARD INSURANCE COMPANY | $4K | $0 | $4K | 0.57% |
| CHRISTOPHER A. BUSSEY3 | 858 NORTH FRANKLIN STREET, UNIT 204 CHICAGO, IL 60610 | STANDARD INSURANCE COMPANY | $13K | $0 | $13K | 2.00% |
| DANNY S. DONLEY3 | 1013 MALEVENTUM SPRING HILL, TN 37174 | STANDARD INSURANCE COMPANY | $13K | $0 | $13K | 2.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 4TH FLOOR ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF OHIO | $5K | $687 | $6K | 1.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2800 LIVERNOIS, SUITE 450 TROY, MI 48083 | DELTA DENTAL OF OHIO | $3K | $686 | $4K | 0.84% |
| SPECTRUM SOURCE BROKERAGE3 | 9535 EAST 59TH STREET, SUITE C INDIANAPOLIS, IN 46216 | STANDARD INSURANCE COMPANY | $43K | $0 | $43K | 10.57% |
| DANNY S. DONLEY3 | 1013 MALEVENTUM SPRING HILL, TN 37174 | STANDARD INSURANCE COMPANY | $26K | $0 | $26K | 6.51% |
| CHRISTOPHER A. BUSSEY3 | 1220 NORTH BOSWORTH AVENUE UNIT 201 CHICAGO, IL 60642 | STANDARD INSURANCE COMPANY | $20K | $0 | $20K | 4.92% |
| BRIAN L. HETTMANSPERGER SR.3 | 10835 BENTWATER LANE FISHERS, IN 46037 | STANDARD INSURANCE COMPANY | $9K | $0 | $9K | 2.27% |
| STEPHEN E. CROWE3 | 9535 EAST 59TH STREET, SUITE C INDIANAPOLIS, IN 46216 | STANDARD INSURANCE COMPANY | $3K | $0 | $3K | 0.79% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $8K | $0 | $8K | 11.37% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $0 | $10K | 14.75% |
| DANNY S. DONLEY3 | 1013 MALEVENTUM SPRING HILL, TN 37174 | PETERSEN INTERNATIONAL UNDERWRITERS | $4K | $0 | $4K | 9.52% |
| SOURCE BROKERAGE, INC.3 | 303 WEST OHIO STREET, UNIT 3804 CHICAGO, IL 60654 | PETERSEN INTERNATIONAL UNDERWRITERS | $2K | $0 | $2K | 4.76% |
| SOURCE BROKERAGE, INC.3 | 9535 EAST 59TH STREET, SUITE C INDIANAPOLIS, IN 46216 | PETERSEN INTERNATIONAL UNDERWRITERS | $2K | $0 | $2K | 4.76% |
| SPECTRUM SOURCE BROKERAGE3 | 9535 EAST 59TH STREET, SUITE C INDIANAPOLIS, IN 46216 | PETERSEN INTERNATIONAL UNDERWRITERS | $2K | $0 | $2K | 4.76% |
| SURE LIFE FINANCIAL GROUP LLC3 Filed as: SURE LIFE FINANCIAL GROUP, LLC | 24118 WEST CHICAGO STREET SUITE 100 PLAINFIELD, IL 60554 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $536 | $0 | $536 | 4.60% |
| THE HORTON GROUP3 Filed as: THE HORTON GROUP, INC. | 10320 ORLAND PARKWAY, SUITE 102 ORLAND PARK, IL 60467 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $524 | $0 | $524 | 4.50% |
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 | 1,009 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 40 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 7 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,056 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF OHIO | 1,642 | $467K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 1,262 | $73K |
| Life insurance | STANDARD INSURANCE COMPANY | 752 | $653K |
| Long-term disability(4 contracts, 3 carriers) | STANDARD INSURANCE COMPANY | 752 | $1.1M |
| Other(4 contracts, 3 carriers) | STANDARD INSURANCE COMPANY | 752 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,642 | — |
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.