| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LB BENEFITS INC | 3901 15TH ST SUITE D MOLINE, IL 61265 | BLUECROSS BLUESHIELD | $11K | $589 | $12K | 0.66% |
| LB BENEFITS INC | 3901 15TH ST SUITE D MOLINE, IL 61265 | BLUECROSS BLUESHIELD | $5K | $460 | $6K | 7.59% |
| LB BENEFITS INC | 3901 15TH ST SUITE D MOLINE, IL 61265 | DEARBORN LIFE INSURANCE COMPANY | $9K | $2K | $11K | 18.35% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS LLC | 1787 SENTRY PKWY W STE 320 BLUE BELL, PA 19422 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $7K | $15K | 26.80% |
| LB BENEFITS INC | 3901 15TH ST SUITE D MOLINE, IL 61265 | VSP VISION CARE | $746 | $0 | $746 | 7.52% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF ILLINOIS EIN 36-1236610 ADMINISTRATIVE SERVICES | Claims processing Service code 12 | — | $96K |
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 | 213 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 36 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 249 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD | 245 | $1.8M |
| Dental | BLUECROSS BLUESHIELD | 195 | $78K |
| Vision | VSP VISION CARE | 108 | $10K |
| Life insurance(2 contracts, 2 carriers) | DEARBORN LIFE INSURANCE COMPANY | 213 | $117K |
| Long-term disability | DEARBORN LIFE INSURANCE COMPANY | 213 | $61K |
| Prescription drug | BLUECROSS BLUESHIELD | 245 | $1.8M |
| Stop-loss / reinsurancereinsurance | BLUECROSS BLUESHIELD | 245 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 245 | — |
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.