| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LUNDSTROM INSURANCE AGENCY3 Filed as: LUNDSTROM INSURANCE AGENCY INC | 2205 POINT BLVD SUITE 200 ELGIN, IL 60123 | STANDARD SECURITY | $26K | $0 | $26K | 10.00% |
| BENEFIT ADMINISTRATIVE SYSTEMS, LLC5 Filed as: BENEFIT ADMINISTRATIVE SYSTEMS LLC | 17475 JOVANNA DRIVE SUITE 1B HOMEWOOD, IL 60430 | STANDARD SECURITY | $14K | $0 | $14K | 5.44% |
| BENEFIT ADMINISTRATIVE SYSTEMS, LLC5 Filed as: BENEFIT ADMINISTRATIVE SYSTEMS LLC | 17475 JOVANNA DRIVE SUITE 1B HOMEWOOD, IL 60430 | BENEFIT ADMINISTRATIVE SYSTEMS LLC | — | $71K | $71K | 94.19% |
| LUNDSTROM INSURANCE AGENCY3 Filed as: LUNDSTROM INSURANCE AGENCY INC | 2205 POINT BLVD SUITE 200 ELGIN, IL 60123 | BENEFIT ADMINISTRATIVE SYSTEMS LLC | $4K | $0 | $4K | 5.81% |
| BLUE CROSS BLUE SHIELD OF FLORIDA5 Filed as: BLUECROSS BLUE SHIELD OF ILLINOIS | 1020 W 31ST STREET DOWNERS GROVE, IL 60515 | BLUECROSS BLUESHIELD OF ILLINOIS | — | $18K | $18K | 35.96% |
| LUNDSTROM INSURANCE AGENCY3 Filed as: LUNDSTROM INSURANCE AGENCY INC | 2205 POINT BLVD SUITE 200 ELGIN, IL 60123 | BLUECROSS BLUESHIELD OF ILLINOIS | $5K | $0 | $5K | 9.83% |
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 | 300 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 306 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BENEFIT ADMINISTRATIVE SYSTEMS LLC | 657 | $125K |
| Dental(2 contracts, 2 carriers) | BENEFIT ADMINISTRATIVE SYSTEMS LLC | 657 | $125K |
| Short-term disability | BENEFIT ADMINISTRATIVE SYSTEMS LLC | 657 | $75K |
| Prescription drug(2 contracts, 2 carriers) | BENEFIT ADMINISTRATIVE SYSTEMS LLC | 657 | $125K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | STANDARD SECURITY | 657 | $313K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 657 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.