| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2315 ENTERPRISE DRIVE SUITE 105 WESTCHESTER, IL 60154 | BLUECROSS BLUESHIELD OF ILLINOIS | $21K | $2K | $23K | 4.46% |
| DURABLE, INC3 | 750 NORTHGATE PARKWAY WHEELING, IL 60090 | BLUECROSS BLUESHIELD OF ILLINOIS | — | $2 | $2 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2315 ENTERPRISE DRIVE SUITE 105 WESTCHESTER, IL 60154 | BLUECROSS BLUESHIELD OF ILLINOIS | — | $2 | $2 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | 2315 ENTERPRISE DRIVE WESTCHESTER, IL 60154 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $47K | $2K | $49K | 22.23% |
| MICHAEL BLOCK3 | 16619 SOUTH PINECREEK DRIVE LOCKPORT, IL 60441 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10K | $13K | $22K | 10.26% |
| JOSHUA T JONES3 | 25 GARFIELD LANE STREAMWOOD, IL 60107 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8K | $14K | $22K | 10.22% |
| TODD M COLVIN3 | 1224A GLEN MOR DRIVE SHOREWOOD, IL 60404 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9K | $6K | $15K | 6.70% |
| DAVID TODD WEINSTEIN3 | 7632 ADAMS STREET FORREST PARK, IL 60130 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $8K | $12K | 5.68% |
| JAIR I SANCHEZ GARCIA3 | 3631 WEST 63RD STREET CHICAGO, IL 60629 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7K | $180 | $8K | 3.49% |
| JORGE ALEJANDRO MONTEMAYOR3 Filed as: JORGE H CASTELLANOS | 7441 FIGURA DRIVE JUSTICE, IL 60458 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | $753 | $7K | 3.24% |
| GERSON GUILLERMO RAMIREZ3 | 1558 ELDER DRIVE AURORA, IL 60506 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $476 | $5K | 2.17% |
| ERIN COLLEEN LANINGA3 | 1700 HIGGINS DES PLAINES, IL 60018 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $420 | $3K | 1.37% |
| IVEN KISER3 | 4223 NORTH RICHMOND STREET CHICAGO, IL 60618 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $135 | $2K | $2K | 0.91% |
| YESENIA A SANCHEZ3 Filed as: YESENIA A HERNANDEZ | 3631 WEST 63RD STREET CHICAGO, IL 60629 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $160 | $2K | 0.87% |
| KRISTIN J QUINLAN3 Filed as: KRISTIN M JONES | 25 GARFIELD LANE STREAMWOOD, IL 60107 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $279 | $1K | 0.59% |
| ANTONELLO TITO3 | 1965 BALMORAL AVENUE WESTCHESTER, IL 60154 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $629 | — | $629 | 0.29% |
| CARMEN G NAVARRETE3 | P.O. BOX 564362 CHICAGO, IL 60656 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $291 | $53 | $344 | 0.16% |
| AGSANT GROUP INC3 | 5500 WEST 35TH STREET CICERO, IL 60804 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $44 | $43 | $87 | 0.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J GALLAGHER & CO. | 2315 ENTERPRISE DRIVE SUITE 105 WESTCHESTER, IL 60154 | COMPANION LIFE INSURANCE COMPANY | $15K | — | $15K | 9.68% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | 2315 ENTERPRISE DRIVE SUITE 105 WESTCHESTER, IL 60154 | DELTA DENTAL OF ILLINOIS | $1K | — | $1K | 6.91% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2315 ENTERPRISE DRIVE SUITE 105 WESTCHESTER, IL 60154 | HARTFORD LIFE AND ACCIDENT | $657 | — | $657 | 17.91% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2 PIERCE PLACE 21ST FLOOR ITASCA, IL 60143 | HARTFORD LIFE AND ACCIDENT | — | $25 | $25 | 0.68% |
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 | 167 | 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) | 167 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 98 | $519K |
| Dental | DELTA DENTAL OF ILLINOIS | 39 | $15K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 55 | $4K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE INSURANCE COMPANY | 199 | $151K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 372 | $223K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 372 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.