| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | P O BOX 632886 CINCINNATI, OH 45263 | BLUECROSS BLUESHIELD OF ILLINOIS | $35K | $774 | $36K | 2.99% |
| THE HORTON GROUP3 | 10320 ORLAND PARKWAY ORLAND PARK, IL 60467 | BLUECROSS BLUESHIELD OF ILLINOIS | $11K | — | $11K | 0.92% |
| THE HORTON GROUP3 | 10320 ORLAND PARKWAY ORLAND PARK, IL 60467 | HEALTHPARTNERS INSURANCE COMPANY | $14K | — | $14K | 2.94% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | P O BOX 632886 CINCINNATI, OH 45263 | HEALTHPARTNERS INSURANCE COMPANY | $3K | $1K | $4K | 0.89% |
| THE HORTON GROUP3 | 10320 ORLAND PARKWAY ORLAND PARK, IL 60467 | GUARDIAN | $4K | — | $4K | 10.00% |
| THE HORTON GROUP3 Filed as: THE HORTON GROUP INC | 10320 ORLAND PARKWAY ORLAND PARK, IL 60467 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 11.64% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | P O BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $199 | $3K | 6.76% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: INSENTIAL INC | 206 S JEFFERSON ST SUITE 200 CHICAGO, IL 60661 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $850 | — | $850 | 2.09% |
| THE HORTON GROUP3 Filed as: THE HORTON GROUP INC | 10320 ORLAND PARKWAY ORLAND PARD, IL 60467 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 11.93% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | P O BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $161 | $2K | 6.69% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: INSENTIAL INC | 206 S JEFFERSON ST STE 200 CHICAGO, IL 60661 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $508 | — | $508 | 2.02% |
| THE HORTON GROUP3 Filed as: THE HORTON GROUP INC | 10320 ORLAND PARKWAY ORLAND PARK, IL 60467 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $667 | — | $667 | 6.09% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | P O BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $321 | $65 | $386 | 3.52% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: INSENTIAL INC | 206 S JEFFERSON ST STE 200 CHICAGO, IL 60661 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $107 | — | $107 | 0.98% |
| THE HORTON GROUP3 Filed as: THE HORTON GROUP INC | 10320 ORLAND PARKWAY ORLAND PARK, IL 60467 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $906 | — | $906 | 11.76% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | P O BOX 632886 CINCINNATI, OH 45263 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $476 | $41 | $517 | 6.71% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: INSENTIAL INC | 206 S JEFFERSON ST STE 200 CHICAGO, IL 60661 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $159 | — | $159 | 2.06% |
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 | 239 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 239 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF ILLINOIS | 155 | $1.7M |
| Dental(2 contracts, 2 carriers) | HEALTHPARTNERS INSURANCE COMPANY | 137 | $511K |
| Vision | GUARDIAN | 137 | $41K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 239 | $33K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 36 | $11K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 239 | $41K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 239 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 239 | — |
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.