| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N. MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $45K | — | $45K | 45.80% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 1000 E. WARRENVILLE RD., STE 230 NAPERVILLE, IL 60563 | BLUE CROSS BLUE SHIELD OF ILLINOIS | — | $3K | $3K | 2.62% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | SUN LIFE ASSURANCE CO OF CANADA | $860 | — | $860 | 1.25% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH &MCLENNAN AGENCY LLC | 20 N MARTINGALERD., STE 100 SCHAUMBURG, IL 60173 | SUN LIFE ASSURANCE CO OF CANADA | $159 | — | $159 | 0.23% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | DEARBORN LIFE INSURANCE CO | $1K | — | $1K | 3.40% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERTICES | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | DEARBORN LIFE INSURANCE CO | — | $863 | $863 | 2.26% |
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 | 138 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 140 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 169 | $98K |
| Dental | SUN LIFE ASSURANCE CO OF CANADA | 81 | $69K |
| Vision | EYEMED | 150 | $6K |
| Life insurance | DEARBORN LIFE INSURANCE CO | 138 | $38K |
| Short-term disability | DEARBORN LIFE INSURANCE CO | 138 | $38K |
| Other | DEARBORN LIFE INSURANCE CO | 138 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 169 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.