| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENNIE INSURANCE, LLC3 | 700 CANAL ST. STAMFORD, CT 06902 | BLUECROSS BLUESHIELD OF ILLINOIS | $47K | $0 | $47K | 2.66% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC. | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | BLUECROSS BLUESHIELD OF ILLINOIS | $22K | $0 | $22K | 1.23% |
| BENNIE INSURANCE, LLC3 | 700 CANAL ST. 1ST FLOOR STAMFORD, CT 06902 | DELTA DENTAL OF ILLINOIS | $5K | $0 | $5K | 4.44% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES, I | 80 S 8TH ST STE 700 MINNEAPOLIS, MA 55402 | DELTA DENTAL OF ILLINOIS | $3K | $0 | $3K | 3.16% |
| BENNIE INSURANCE, LLC3 | 200 BROADWAY, 3RD FLOOR NEW YORK, NY 10038 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $0 | $5K | 8.59% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INSURANCE AGENCY | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 4.65% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC. | 225 WIRELESS BOULEVARD, 2ND FLOOR HAUPPAUGE, NY 11788 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 4.38% |
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 | 161 | 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) | 161 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 249 | $1.8M |
| Dental | DELTA DENTAL OF ILLINOIS | 142 | $107K |
| Vision | DELTA DENTAL OF ILLINOIS | 142 | $107K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 192 | $62K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 192 | $62K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 192 | $62K |
| Prescription drug | BLUECROSS BLUESHIELD OF ILLINOIS | 249 | $1.8M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 192 | $62K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 249 | — |
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.