| 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 | $29K | $0 | $29K | 0.39% |
| WIRTZ INSURANCE AGENCY, INC3 Filed as: WIRTZ INSURANCE AGENCY, INC. | 680 N LAKE SHORE DRIVE 19TH FLOOR CHICAGO, IL 60611 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15K | $0 | $15K | 5.63% |
| WIRTZ INSURANCE AGENCY, INC3 | 680 N LAKE SHORE DRIVE, 19TH FLOOR CHICAGO, IL 60611 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $0 | $10K | 10.34% |
| WIRTZ INSURANCE AGENCY, INC3 | 680 N. LAKE SHORE DRIVE, 19TH FLOOR CHICAGO, IL 60611 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 5.77% |
| WIRTZ INSURANCE AGENCY, INC3 | 680 N LAKE SHORE DRIVE, 19TH FLOOR CHICAGO, IL 60611 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $0 | $8K | 9.57% |
| 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 | $8K |
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 | 1,041 | 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) | 1,041 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTHCARE SERVICE CORPORATION | 1,041 | $7.4M |
| Dental | HEALTHCARE SERVICE CORPORATION | 1,041 | $7.4M |
| Vision | HEALTHCARE SERVICE CORPORATION | 1,041 | $7.4M |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 177 | $94K |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 535 | $342K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 177 | $188K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,041 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
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.