| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCHC INSURANCE SERVICES INC3 | 222 S RIVERSIDE PLAZA, 19TH FLOOR CHICAGO, IL 60606 | BLUECROSS BLUESHIELD OF ILLINOIS | $41K | — | $41K | 0.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 100 ILLINOIS ST. SUITE 207 ST. CHARLES, IL 60174 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $22K | — | $22K | 6.82% |
| MCHC INSURANCE SERVICES INC3 Filed as: MCHC INSURANCE SERVICES INC. | 222 S RIVERSIDE PLZ, SUITE 1900 CHICAGO, IL 606065808 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 0.71% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | P.O BOX 3009 ARLINGTON HEIGHTS, IL 60006 | EYEMED VISION CARE | $98 | — | $98 | 0.37% |
| EOI SERVICE COMPANY INC3 Filed as: EOI SERVICE COMPANY | 900 N FRANKLIN ST #900 CHICAGO, IL 60610 | COMBINED INSURANCE | $13K | — | $13K | 56.79% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 100 ILLINOIS ST SUITE 207 ST. CHARLES, IL 60174 | COMBINED INSURANCE | $7K | — | $7K | 30.58% |
| JAMES D DAVIDSON3 | 1820 E 1ST STREET SUITE 400 SANTA ANA, CA 92705 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $8K | — | $8K | 43.35% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4K | — | $4K | 23.25% |
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 | 540 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 544 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 684 | $4.2M |
| Dental | AETNA LIFE INSURANCE COMPANY | 781 | $242K |
| Vision | EYEMED VISION CARE | 382 | $26K |
| Life insurance(2 contracts, 2 carriers) | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 538 | $345K |
| Short-term disability | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 538 | $322K |
| Long-term disability | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 538 | $322K |
| Other(2 contracts, 2 carriers) | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 538 | $341K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 781 | — |
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.