| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE BJORK GROUP INC3 Filed as: BJORK GROUP INC | 1033 NORTH SKOKIE BOULEVARD SUITE 210 NORTHBROOK, IL 60062 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | — | $3K | 0.83% |
| THE BJORK GROUP INC3 | 1033 NORTH SKOKIE BOULEVARD SUITE 210 NORTHBROOK, IL 66062 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | $569 | $8K | 9.92% |
| NATIONAL BENEFIT CENTER3 Filed as: NATIONAL BENEFIT CENTER LLC | 1105 NORTH MARKET STREET SUITE 1300 WILMINGTON, DE 19601 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $953 | — | $953 | 1.19% |
| MARK J MATSOCK & ASSOCIATES INC3 Filed as: MARK C PIETSCH | 10616 CRYSTAL SPRINGS LAKE ORLANDO PARK, IL 60467 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $233 | — | $233 | 0.29% |
| THE PIETSCH FINANCIAL GROUP3 Filed as: THE PIETSCH FINANCIAL GROUP INC | 1751 LAKE COOK ROAD SUITE 350 DEERFIELD, IL 60015 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3 | — | $3 | 0.00% |
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 | 115 | 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) | 115 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 121 | $301K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 115 | $80K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 115 | $80K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 115 | $80K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 115 | $80K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 115 | $80K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 121 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.