| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE | 2800 RIVER ROAD SUITE 300 DES PLAINES, IL 60018 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $66K | $0 | $66K | 3.75% |
| ANDREW JACKSON3 | 1654 S. RIDGE ROAD LAKE FOREST, IL 60045 | METROPOLITAN LIFE INSURANCE COMPANY | $13K | $0 | $13K | 9.92% |
| BSP GROUP BENEFITS INC3 Filed as: BSP GROUP | 206 S. JEFFERSON STREET SUITE 200 CHICAGO, IL 60661 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | $0 | $7K | 4.96% |
| DREW JACKSON3 | 1654 S. RIDGE ROAD LAKE FOREST, IL 60045 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.22% |
| ANDREW JACKSON3 | 1654 S. RIDGE ROAD LAKE FOREST, IL 60045 | GUARDIAN LIFE INSURANCE | $2K | $0 | $2K | 9.96% |
| BENEFITS SERVICE PLUS, INC3 | 1827 W. OAKDALE UNIT D CHICAGO, IL 60657 | GUARDIAN LIFE INSURANCE | $912 | — | $912 | 6.04% |
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 | 162 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 25 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 187 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 317 | $1.8M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 284 | $147K |
| Vision | VISION SERVICE PLAN | 141 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 317 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.