| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FIRST STATE INSURANCE LLC3 Filed as: FIRST STATE INSURANCE | 713 WASHINGTON ST PO BOX 497 MENDOTA, IL 61342 | HCSC | $58K | — | $58K | 3.81% |
| GROUP BROKERAGE CONSULTANTS3 | PO BOX 1582 LA SALLE, IL 61301 | STANDARD INSURANCE COMPANY | $22K | — | $22K | 15.14% |
| GROUP BROKERAGE CONSULTANTS3 | PO BOX 1582 LA SALLE, IL 61301 | STANDARD INSURANCE COMPANY | $766 | — | $766 | 0.79% |
| GROUP BROKERAGE CONSULTANTS3 | PO BOX 1582 LA SALLE, IL 61301 | STANDARD INSURANCE COMPANY | $511 | — | $511 | 0.82% |
| FIRST STATE INSURANCE LLC3 Filed as: FIRST STATE INSURANCE | PO BOX 497 MENDOTA, IL 61342 | HARTFORD LIFE AND ACCIDENT | $552 | — | $552 | 15.00% |
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 | 195 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 197 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HCSC | 310 | $1.5M |
| Dental | STANDARD INSURANCE COMPANY | 181 | $143K |
| Vision | STANDARD INSURANCE COMPANY | 181 | $143K |
| Life insurance | STANDARD INSURANCE COMPANY | 187 | $97K |
| Long-term disability | STANDARD INSURANCE COMPANY | 187 | $63K |
| Prescription drug | HCSC | 310 | $1.5M |
| Other(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 187 | $100K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 310 | — |
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.