| 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 | $117K | $3K | $120K | 3.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2315 ENTERPRISE DR STE 105 WESTCHESTER, IL 60154 | BLUECROSS BLUESHIELD OF ILLINOIS | — | $24 | $24 | 0.00% |
| AMERICAN LIBRARY ASSOCIATION4 | 50 E HURON ST CHICAGO, IL 60611 | BLUECROSS BLUESHIELD OF ILLINOIS | — | $9 | $9 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 127 NORTH WALNUT STREET ITASCA, IL 60143 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | $11K | $18K | 7.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2315 ENTERPRISE DR STE 105 WESTCHESTER, IL 60154 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 6.36% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | 400 MIDLAND DR STE 300 MOUNT LAUREL, NJ 08054 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 1.23% |
| AXA ASSISTANCE, USA3 Filed as: AXA ASSISTANCE USA | 122 S MICHIGAN AVE STE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $88 | $88 | 0.06% |
| EUGENE TKALITCH & ASSOCIATES LTD3 Filed as: EUGENE TKALITCH AND ASSOCIATES LTD | 6601 N AVONDALE AVE CHICAGO, IL 60659 | FEDERAL INSURANCE COMPANY | $315 | — | $315 | 15.00% |
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 | 257 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 113 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 370 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | BLUECROSS BLUESHIELD OF ILLINOIS | 508 | $4.0M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 316 | $251K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 316 | $251K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 364 | $138K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 364 | $138K |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 364 | $140K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 508 | — |
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."
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.