| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WIRTZ INSURANCE AGENCY, INC3 | 680 N. LAKE SHORE DRIVE, 19TH FLOOR CHICAGO, IL 60611 | HEALTHCARE SERVICE CORPORATION | $130K | $0 | $130K | 0.85% |
| WIRTZ INSURANCE AGENCY, INC3 | 680 N. LAKE SHORE DRIVE, 19TH FLOOR CHICAGO, IL 60611 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $25K | $0 | $25K | 5.63% |
| WIRTZ INSURANCE AGENCY, INC3 | 680 N LAKE SHORE DRIVE, 19TH FLOOR CHICAGO, IL 60611 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $30K | $0 | $30K | 12.28% |
| WIRTZ INSURANCE AGENCY, INC3 | 680 N LAKE SHORE DRIVE, 19TH FLOOR CHICAGO, IL 60611 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $21K | $0 | $21K | 9.26% |
| WIRTZ INSURANCE AGENCY, INC3 | 680 N LAKE SHORE DRIVE, 19TH FLOOR CHICAGO, IL 60611 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $14K | $0 | $14K | 6.68% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNUM LIFE INSURANCE CO OF AMERICA EIN 01-0278678 N/A | Other services; Other fees Service code 49 | 1 FOUNTAIN SQUARE CHATTANOOGA, TN 37402 | $22K |
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 | 3,779 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,779 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTHCARE SERVICE CORPORATION | 3,779 | $15.4M |
| Dental | HEALTHCARE SERVICE CORPORATION | 3,779 | $15.4M |
| Vision | HEALTHCARE SERVICE CORPORATION | 3,779 | $15.4M |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 809 | $444K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,445 | $232K |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,845 | $891K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,779 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.