| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N. MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | BLUE CROSS BLUE SHIELD OF ILLINOIS | — | $7K | $7K | 1.50% |
| AMWINS5 | 50 WHITECAP DRIVE N. KINGSTON, RI 02852 | EXPRESS SCRIPTS PRESCRIPTION DRUG PLAN | $8K | — | $8K | 3.05% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N. MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | UNITED OF OMAHA LIFE INSURANCE CO | $20K | $6K | $27K | 15.33% |
| MARSH & MCLENNAN AGENCY LLC3 | 20 N MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | UNITED OF OMAHA LIFE INSURANCE CO | $4K | — | $4K | 2.18% |
| AMWINS5 | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | TRANSAMERICA INSURANCE CO MEDICARE SUPPLEMENT | $21K | — | $21K | 12.37% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N. MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | VISION SERVICE PLAN | $4K | — | $4K | 9.20% |
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 | 532 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 130 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 662 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | TRANSAMERICA INSURANCE CO MEDICARE SUPPLEMENT | 114 | $169K |
| Vision | VISION SERVICE PLAN | 326 | $44K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE CO | 453 | $174K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE CO | 453 | $174K |
| Prescription drug | EXPRESS SCRIPTS PRESCRIPTION DRUG PLAN | 114 | $252K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF ILLINOIS | 1,050 | $459K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE CO | 453 | $181K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,050 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.