| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 222 SOUTH RIVERSIDE PLAZA SUITE 630 CHICAGO, IL 60606 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $3K | $0 | $3K | 0.09% |
| USI INSURANCE SERVICES LLC3 | 1721 MAGNAVOX WAY FORT WAYNE, IN 46804 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $0 | $25 | $25 | 0.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: INSENTIAL, INC. | 206 SOUTH JEFFERSON STREET SUITE 200 CHICAGO, IL 60661 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | $133 | $9K | 5.03% |
| USI INSURANCE SERVICES LLC3 | PO BOX 3716 NORFOLK, VA 23514 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $742 | $0 | $742 | 0.83% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $108 | $108 | 0.12% |
| USI INSURANCE SERVICES LLC3 | 222 SOUTH RIVERSIDE PLAZA SUITE 630 CHICAGO, IL 60606 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.16% |
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 | 301 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 18 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 319 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 509 | $2.9M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 625 | $176K |
| Vision | VISION SERVICE PLAN | 190 | $21K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 301 | $89K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 301 | $89K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ILLINOIS | 509 | $2.9M |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 301 | $89K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 625 | — |
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.