| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | 20 NORTH MARTINGALE ROAD SUITE 100 SCHAUMBURG, IL 60173 | BLUECROSS BLUESHIELD OF ILLINOIS | $114K | $9K | $123K | 2.27% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS, INC. | 2290 LUCIEN WAY, SUITE 400 MAITLAND, FL 32751 | BLUECROSS BLUESHIELD OF ILLINOIS | $74K | — | $74K | 1.37% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES (IL) | 500 WEST MADISON STREET, 32ND FLOOR CHICAGO, IL 60661 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $30K | $4K | $34K | 11.37% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS, INC. | 2290 LUCIEN WAY, SUITE 400 MAITLAND, FL 32751 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $19K | $3K | $22K | 7.25% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | 2300 RENAISSANCE BOULEVARD KING OF PRUSSIA, PA 19406 | DEARBORN LIFE INSURANCE COMPANY | $0 | $5K | $5K | 2.59% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS, INC. | 300 NORTH BEACH STREET DAYTONA BEACH, FL 32114 | DEARBORN LIFE INSURANCE COMPANY | $3K | $0 | $3K | 1.66% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES (IL) | 500 WEST MADISON STREET, 32ND FLOOR CHICAGO, IL 60661 | UNUM INSURANCE COMPANY | $3K | $459 | $4K | 18.25% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS, INC. | 2290 LUCIEN WAY, SUITE 400 MAITLAND, FL 32751 | UNUM INSURANCE COMPANY | $6 | $1 | $7 | 0.03% |
| MARSH & MCLENNAN AGENCY LLC4 Filed as: MARSH & MCLENNAN AGENCY, LLC | 20 NORTH MARTINGALE ROAD SUITE 100 SCHAUMBURG, IL 60173 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $2K | — | $2K | 13.08% |
| ALAN ROMAN4 | 7220 PRINCETON AVENUE SAINT LOUIS, MO 63130 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $472 | $0 | $472 | 3.90% |
| ANTHONY W KOEHLER4 Filed as: ANTHONY W. KOEHLER | 766 EAST COUNTY ROAD 600 WARSAW, IL 62379 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $39 | — | $39 | 0.32% |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 556 | $5.4M |
| Dental | BLUECROSS BLUESHIELD OF ILLINOIS | 556 | $5.4M |
| Vision | DEARBORN LIFE INSURANCE COMPANY | 262 | $195K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 262 | $494K |
| Short-term disability | DEARBORN LIFE INSURANCE COMPANY | 262 | $195K |
| Long-term disability | DEARBORN LIFE INSURANCE COMPANY | 262 | $195K |
| Prescription drug | BLUECROSS BLUESHIELD OF ILLINOIS | 556 | $5.4M |
| Other(4 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 262 | $528K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 556 | — |
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.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.