| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES, INC. | UNKNOWN CHICAGO, IL 60611 | BLUECROSS BLUESHIELD OF ILLINOIS | $42K | $4K | $45K | 2.19% |
| USI INSURANCE SERVICES LLC3 | 222 SOUTH RIVERSIDE PLAZA SUITE 900 CHICAGO, IL 60606 | BLUECROSS BLUESHIELD OF ILLINOIS | $14K | $0 | $14K | 0.69% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES, INC. | 353 NORTH CLARK STREET, CHICAGO, IL 60654 | SUN LIFE ASSURANCE COMPANY OF CANADA | $6K | $3K | $9K | 9.83% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | $0 | $2K | 2.46% |
| ALLIANT INSURANCE SERVICES, INC.3 | 353 NORTH CLARK STREET CHICAGO, IL 60654 | SUN LIFE ASSURANCE COMPANY OF CANADA | $742 | $0 | $742 | 0.81% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES, INC. | 353 NORTH CLARK STREET, SUITE 400 CHICAGO, IL 60654 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $1K | $0 | $1K | 6.68% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET SAN DIEGO, CA 92101 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $251 | $0 | $251 | 1.68% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $248 | $0 | $248 | 1.66% |
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 | 141 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 152 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 262 | $2.1M |
| Dental | BLUECROSS BLUESHIELD OF ILLINOIS | 262 | $2.1M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 248 | $15K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 141 | $92K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 141 | $92K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 141 | $92K |
| Prescription drug | BLUECROSS BLUESHIELD OF ILLINOIS | 262 | $2.1M |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 141 | $92K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 262 | — |
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.