| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES, INC. | 353 N CLARK ST STE 1100 CHICAGO, IL 60654 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $12K | $3K | $15K | 10.02% |
| BENEFIT ADVISORS SVCS GRP LLC3 | 1125 SANCTUARY PKWY STE 300 ALPHARETTA, GA 30009 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 1.00% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES, INC. | 353 NORTH CLARK ST CHICAGO, IL 60654 | TOKIO MARINE HCC | $3K | — | $3K | 10.00% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES, INC. | 353 NORTH CLARK ST #400 CHICAGO, IL 60654 | EYEMED | $3K | — | $3K | 12.09% |
| LYNN KITSON3 Filed as: LYNN KITSON (MATTEI) | 58053 CRYSTAL SPRINGS DR GOSHEN, IN 46528 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 13.81% |
| MWL3 | PO BOX 14067 JACKSON, MS 39236 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $515 | — | $515 | 2.60% |
| LYNN KITSON3 Filed as: LYNN KITSON (MATTEI) | 58053 CRYSTAL SPRINGS DR GOSHEN, IN 46528 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 11.90% |
| MWL3 | PO BOX 14067 JACKSON, MS 39236 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $498 | — | $498 | 2.59% |
| LYNN KITSON3 Filed as: LYNN KITSON (MATTEI) | 58053 CRYSTAL SPRINGS DR GOSHEN, IN 46528 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 11.98% |
| MWL3 | PO BOX 14067 JACKSON, MS 39236 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $242 | — | $242 | 2.60% |
| LYNN KITSON3 Filed as: LYNN KITSON (MATTEI) | 58053 CRYSTAL SPRINGS DR GOSHEN, IN 46528 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $688 | — | $688 | 12.00% |
| MWL3 | PO BOX 14067 JACKSON, MS 39236 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $154 | — | $154 | 2.69% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GROUP ADMINISTRATORS, LTD. EIN 36-3381052 NONE | Claims processing Service code 12 | 953 AMERICAN LANE SUITE 100 SCHAUMBURG, IL 60173 | $66K |
| MESIROW INS SERVICES INC. EIN 36-3429604 NONE | Insurance agents and brokers Service code 22 | — | $53K |
| CIGNA CORPORATION EIN 59-1031071 NONE | Other fees Service code 99 | — | $51K |
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 | 229 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 229 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 206 | $146K |
| Vision | EYEMED | 394 | $23K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 278 | $19K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 271 | $9K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 271 | $20K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF AMERICA | 229 | $529K |
| Other(2 contracts, 2 carriers) | TOKIO MARINE HCC | 278 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 394 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.