| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIRO INSURANCE SERVICES | 353 N CLARK ST CHICAGO, IL 60654 | HEALTH RESOURCES, INC. | $9K | — | $9K | 10.00% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW FINANCIAL | 353 NORTH CLARK ST CHICAGO, IL 60654 | AIG BENEFIT SOLUTIONS | $4K | — | $4K | 10.00% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INS SERVICES INC | 353 NORTH CLARK ST CHICAGO, IL 60654 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $817 | $5K | 17.73% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES | 353 N CLARK ST CHICAGO, IL 60654 | AMERITAS INSURANCE CORP. | $2K | — | $2K | 10.05% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES | 353 NORTH CLARK ST CHICAGO, IL 60654 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $364 | $3K | 17.51% |
| LYNN KITSON3 | 58053 CYRSTAL SPRINGS DR GOSHEN, IN 46528 | VISION SERVICE PLAN | $724 | — | $724 | 7.64% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES | 1500 S LAKESIDE DRIVE BANNOCKBURN, IL 60015 | FEDERAL INSURANCE COMPANY | $717 | — | $717 | 15.85% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GROUP ADMINISTRATORS, LTD. EIN 36-3381052 NONE | Claims processing Service code 12 | 915 NATIONAL PARKWAY SUITE F SCHAUMBURG, IL 60173 | $60K |
| CIGNA CORPORATION EIN 59-1031071 NONE | Other fees Service code 99 | — | $35K |
| MESIROW INSURANCE SERVICES EIN 36-3429604 NONE | Insurance agents and brokers Service code 22 | — | $12K |
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 | 210 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 210 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | HEALTH RESOURCES, INC. | 193 | $89K |
| Vision(2 contracts, 2 carriers) | AMERITAS INSURANCE CORP. | 290 | $27K |
| Life insurance | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 250 | $14K |
| Long-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 238 | $30K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE | 218 | $342K |
| Other(3 contracts, 3 carriers) | AIG BENEFIT SOLUTIONS | 250 | $61K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 290 | — |
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."
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.