| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS SERVICES LLC | — | BLUECROSS BLUESHIELD OF ILLINOIS | — | $990 | $990 | 0.15% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWN INSURANCE SERVICES | PO BOX 300417 CHICAGO, IL 60630 | VISION SERVICE PLAN | $1K | — | $1K | 6.13% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER, INC | PO BOX 28 DUBUQUE, IA 52004 | VISION SERVICE PLAN | $778 | — | $778 | 3.92% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INS SVCS, LLC | 303 WEST MADISON STREET SUITE 2000 CHICAGO, IL 60606 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $501 | — | $501 | 7.58% |
| COTTINGHAM & BUTLER3 | PO BOX 28 DUBUQUE, IA 52004 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $293 | — | $293 | 4.43% |
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 | 233 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 235 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 175 | $20K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 233 | $65K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 233 | $49K |
| Stop-loss / reinsurancereinsurance | BLUECROSS BLUESHIELD OF ILLINOIS | 349 | $650K |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 233 | $72K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 349 | — |
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."
No prospect flags tripped on this filing.