| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AFFILIATED BENEFIT CONSULTANTS3 | 1111 W 22ND STREET, STE 620 OAK BROOK, IL 60523 | BLUECROSS BLUESHIELD | — | $7K | $7K | 0.04% |
| AFFILIATED BENEFIT CONSULTANTS3 | 1111 22ND W STREET, STE 620 OAK BROOK, IL 60523 | BLUECROSS BLUESHIELD | — | $2K | $2K | 0.09% |
| KEVIN M. OLSON3 Filed as: KEVIN OLSON | 1901 BUTTERFIELD ROAD, STE 300 DOWNERS GROVE, IL 60515 | RELIANCE STANDARD | $39K | — | $39K | 8.00% |
| SETH KALKSTEIN3 | 29 S MAIN STREET, STE 201 WEST HARTFORD, CT 06107 | RELIANCE STANDARD | $29K | — | $29K | 6.00% |
| E. AMATA3 Filed as: EP AMATA | 29 S MAIN STREET, STE 201 WEST HARTFORD, CT 06107 | RELIANCE STANDARD | $29K | — | $29K | 6.00% |
| KEVIN M. OLSON3 Filed as: KEVIN OLSON | 1901 BUTTERFILED ROAD, STE 300 DOWNERS GROVE, IL 60515 | RELIANCE STANDARD | $20K | — | $20K | 8.00% |
| SETH KALKSTEIN3 | 29 S MAIN STREET, STE 201 WEST HARTFORD, CT 06107 | RELIANCE STANDARD | $15K | — | $15K | 6.00% |
| E. AMATA3 Filed as: EP AMATA | 29 S MAIN STREET, STE 201 WEST HARTFORD, CT 06107 | RELIANCE STANDARD | $15K | — | $15K | 6.00% |
| KEVIN M. OLSON3 Filed as: KEVIN OLSON | 1901 BUTTERFIELD ROAD, STE 300 DOWNERS GROVE, IL 60515 | RELIANCE STANDARD | $13K | — | $13K | 8.00% |
| SETH KALKSTEIN3 | 29 S MAIN STREET, STE 201 WEST HARTFORD, CT 06107 | RELIANCE STANDARD | $9K | — | $9K | 6.00% |
| E. AMATA3 Filed as: EP AMATA | 29 S MAIN STREET, STE 201 WEST HARTFORD, CT 06107 | RELIANCE STANDARD | $9K | — | $9K | 6.00% |
| KEVIN M. OLSON3 Filed as: KEVIN OLSON | 1901 BUTTERFIELD ROAD, STE 300 DOWNERS GROVE, IL 60515 | RELIANCE STANDARD | $10K | — | $10K | 8.00% |
| SETH KALKSTEIN3 | 29 S MAIN STREET, STE 201 WEST HARTFORD, CT 06107 | RELIANCE STANDARD | $8K | — | $8K | 6.00% |
| E. AMATA3 Filed as: EP AMATA | 29 S MAIN STREET, STE 201 WEST HARTFORD, CT 06107 | RELIANCE STANDARD | $8K | — | $8K | 6.00% |
| AFFILIATED BENEFIT CONSULTANTS3 Filed as: AFFILIATED BENEFIT CONSULTANTS, INC | 1111 W 22ND STREET, STE 620 OAK BROOK, IL 60523 | EYEMED VISION CARE | $9K | — | $9K | 9.90% |
| AFFILIATED BENEFIT CONSULTANTS3 | 1111 W 22ND STREET SUITE 620 OAK BROOK, IL 60523 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 10.00% |
| KEVIN M. OLSON3 Filed as: KEVIN OLSON | 1901 BUTTERFIELD ROAD, STE 300 DOWNERS GROVE, IL 60515 | RELIANCE STANDARD | $2K | — | $2K | 6.00% |
| SETH KALKSTEIN3 | 29 S MAIN STREET, STE 201 WEST HARTFORD, CT 06107 | RELIANCE STANDARD | $2K | — | $2K | 4.50% |
| E. AMATA3 Filed as: EP AMATA | 29 S MAIN STREET, STE 201 WEST HARTFORD, CT 06107 | RELIANCE STANDARD | $2K | — | $2K | 4.50% |
| AFFILIATED BENEFIT CONSULTANTS3 Filed as: AFFILIATED BENEFIT CONSULTANTS, INC | 1111 W. 22ND STREET, STE. 620 OAK BROOK, IL 60523 | EYEMED VISION CARE | $83 | — | $83 | 10.67% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF ILLINOIS EIN 36-1236610 STOP LOSS PROVIDER | Direct payment from the plan; Claims processing; Insurance services; Contract Administrator Service code 12 | — | $485K |
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 | 1,766 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 21 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,787 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | BLUECROSS BLUESHIELD | 2,089 | $17.3M |
| Dental(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD | 2,089 | $15.4M |
| Vision(2 contracts) | EYEMED VISION CARE | 1,769 | $90K |
| Life insurance(2 contracts) | RELIANCE STANDARD | 1,766 | $375K |
| Short-term disability | RELIANCE STANDARD | 185 | $158K |
| Long-term disability | RELIANCE STANDARD | 1,539 | $485K |
| Stop-loss / reinsurancereinsurance | BLUECROSS BLUESHIELD | 2,089 | $15.3M |
| Other | RELIANCE STANDARD | 1,798 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,089 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.