| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N. MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $111K | $5K | $115K | 23.78% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N. MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | UNUM LIFE INSURANCE CO | $11K | $4K | $15K | 6.91% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N. MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | UNUM LIFE INSURANCE CO | $11K | $1K | $13K | 16.75% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N. MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | VISION SERVICE PLAN | $1K | — | $1K | 4.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| INTERFLEX PAYMENTS, LLC EIN 27-2256926 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $1K |
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 | 342 | 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) | 343 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 267 | $29K |
| Life insurance | UNUM LIFE INSURANCE CO | 406 | $222K |
| Short-term disability | UNUM LIFE INSURANCE CO | 406 | $222K |
| Long-term disability | UNUM LIFE INSURANCE CO | 406 | $222K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF ILLINOIS | 752 | $484K |
| Other(2 contracts) | UNUM LIFE INSURANCE CO | 406 | $297K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 752 | — |
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.