| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | ONE CENTURY CENTRE 1750 EAST GOLF RD SCHAUMBURG, IL 60173 | BLUE CROSS BLUE SHIELD OF ILLINOIS | — | $2K | $2K | 0.09% |
| ASSURANCE AGENCY LTD3 | ONE CENTURY CENTRE 1750 EAST GOLF RD SCHAUMBURG, IL 60173 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $2K | $2K | 2.12% |
| ASSURANCE AGENCY LTD3 | ONE CENTURY CENTRE 1750 EAST GOLF RD SCHAUMBURG, IL 60173 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 2.23% |
| ASSURANCE AGENCY LTD3 | ONE CENTURY CENTRE 1750 EAST GOLF RD SCHAUMBURG, IL 60173 | LIFE INSURNACE COMPANY OF NORTH AMERICA | — | $149 | $149 | 2.21% |
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 | 277 | 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) | 277 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 497 | $2.6M |
| Dental | CIGNA HEALTH & LIFE INSURANCE CO | 252 | $205K |
| Vision | EYEMED VISION CARE | 394 | $19K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 275 | $89K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 261 | $47K |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 275 | $96K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 497 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.