| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES INC. | 353 NORTH CLARK STREET, SUITE 1100 CHICAGO, IL 60654 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $31K | $2K | $34K | 2.25% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES INC. | 353 NORTH CLARK STREET, SUITE 1100 CHICAGO, IL 60654 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | — | $2K | 3.06% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1 WEST 4TH STREET, SUITE 1300 CINCINNATI, OH 45202 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 1.82% |
| UNITED BENEFITS ADVISORS INC3 Filed as: UNITED BENEFITS ADVISORS, INC. | 10 WUNSHINE LANE RED LION, PA 17356 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $326 | $326 | 0.41% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES INC. | 353 NORTH CLARK STREET, SUITE 1100 CHICAGO, IL 60654 | UNITEDHEALTHCARE INSURANCE COMPANY | $2K | — | $2K | 4.60% |
| BENEFIT & COMPENSATION SPECIALISTS3 | 1100 NASA PARKWAY, SUITE 558 HOUSTON, TX 77058 | UNITEDHEALTHCARE INSURANCE COMPANY | — | -$634 | -$634 | -1.38% |
| SURE LIFE FINANCIAL GROUP LLC3 Filed as: SURE LIFE FINANCIAL GROUP, LLC | 24118 WEST CHICAGO STREET SUITE 1000 JACKSONVILLE, FL 32202 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $900 | — | $900 | 4.62% |
| THE HORTON GROUP3 Filed as: THE HORTON GROUP, INC. | 10320 ORLAND PARKWAY, SUITE 102 ORLAND PARK, IL 60467 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $876 | — | $876 | 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 | 144 | 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) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 172 | $1.5M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 156 | $46K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 156 | $46K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 134 | $79K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 134 | $79K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 134 | $79K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ILLINOIS | 172 | $1.5M |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 134 | $99K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 172 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.