| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | — | BLUECROSS BLUESHIELD OF ILLINOIS | $22K | $1K | $23K | 4.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 1000 E WARRENVILLE ROAD SUITE 230 NAPERVILLE, IL 60563 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | — | $3K | 6.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | — | $178 | $178 | 0.34% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 1000 EAST WARRENVILLE ROAD SUITE 230 NAPERVILLE, IL 60563 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | — | $3K | 5.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | — | $126 | $126 | 0.26% |
| HOFF, CHASE3 | 1776 AMERICAN HERITAGE DRIVE JACKSONVILLE, FL 32224 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4K | — | $4K | 10.54% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE INC | 1000 EAST WARRENVILLE ROAD SUITE 230 NAPERVILLE, IL 60563 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | — | $3K | 7.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 1000 EAST WARRENVILLE ROAD SUITE 230 NAPERVILLE, IL 60563 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 4.56% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | — | $77 | $77 | 0.28% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 1000 EAST WARRENVILLE ROAD SUITE 230 NAPERVILLE, IL 60563 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 7.69% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | — | $73 | $73 | 0.38% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | — | DELTA DENTAL OF ILLINOIS | $887 | — | $887 | 8.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1000 EAST WARRENVILLE DRIVE #230 NAPERVILLE, IL 60563 | FIDELITY SECURITY LIFE (FSL) | $471 | — | $471 | 10.00% |
| FRINGE INSURANCE BENEFITS, INC.3 Filed as: FRINGE INSURANCE BENEFITS INC. | 11910 ANDERSON MILL ROAD AUSTIN, TX 78726 | FIDELITY SECURITY LIFE (FSL) | $377 | — | $377 | 8.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | DEARBORN LIFE INSURANCE COMPANY | $504 | $167 | $671 | 20.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1000 EAST WARRENVILLE DRIVE #230 NAPERVILLE, IL 60563 | NATIONWIDE | $55 | — | $55 | 9.95% |
| FRINGE INSURANCE BENEFITS, INC.3 Filed as: FRINGE INSURANCE BENEFITS INC. | 11910 ANDERSON MILL ROAD AUSTIN, TX 78726 | NATIONWIDE | $28 | — | $28 | 5.06% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1000 EAST WARRENVILLE DRIVE #230 NAPERVILLE, IL 60563 | CRUM & FORESTER | $8 | — | $8 | 9.52% |
| FRINGE INSURANCE BENEFITS, INC.3 Filed as: FRINGE INSURANCE BENEFITS INC. | 11910 ANDERSON MILL ROAD AUSTIN, TX 78726 | CRUM & FORESTER | $5 | — | $5 | 5.95% |
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 | 156 | 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) | 156 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 83 | $516K |
| Dental | DELTA DENTAL OF ILLINOIS | 29 | $11K |
| Life insurance(2 contracts, 2 carriers) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 156 | $45K |
| Other(9 contracts, 5 carriers) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 202 | $198K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 202 | — |
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.