| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MESIROW INSURANCE SERVICES INC3 | 353 NORTH CLARK STREET CHICAGO, IL 60654 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15K | $2K | $17K | 17.00% |
| MESIROW INSURANCE SERVICES INC3 | 353 NORTH CLARK STREET CHICAGO, IL 60654 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $1K | $9K | 17.00% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW FINANCIAL - CHICAGO, IL | 353 NORTH CLARK STREET SUITE 400 CHICAGO, IL 60654 | EYEMED VISION CARE THE EYE CARE PLAN OF AMERICA | $4K | — | $4K | 10.55% |
| MESIROW INSURANCE SERVICES INC3 | 353 N CLARK ST CHICAGO, IL 60654 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $148 | $5K | 22.66% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES, INC. | 353 N CLARK STREET CHICAGO, IL 60654 | NATIONAL UNION FIRE INS. CO. OF PITTSBURG, PA | $2K | — | $2K | 15.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARCH & MCLENNAN AGENCY LLC | 32358 COLLECTION CENTER DRIVE CHICAGO, IL 60693 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $106 | — | $106 | 1.92% |
| MCKELVEY, PHILIP, NEILL3 Filed as: MCKELVEY, PHILLIP N | 3931 S DIXIE DR DAYTON, OH 45439 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $74 | — | $74 | 1.34% |
| VOLUNTARY BENEFITS PLUS LLC3 | 9482 WEDGEWOOD BLVD STE 200 POWELL, OH 43065 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.33% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 CLAIM ADMIN | Contract Administrator; Non-monetary compensation; Claims processing; Named fiduciary; Participant communication; Other services; Direct payment from the plan; Float revenue Service code 12 | — | $246K |
| UNUM LIFE INSURANCE COMPANY OF AMER EIN 01-0278678 N/A | Contract Administrator Service code 13 | — | $8K |
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 | 310 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 19 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 329 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE THE EYE CARE PLAN OF AMERICA | 479 | $36K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 329 | $107K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 326 | $54K |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 329 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 479 | — |
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.