| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 | FOUR WESTBROOK CORPORATE CENTER SUITE 500 WESTCHESTER, IL 60154 | BLUECROSS BLUESHIELD OF ILLINOIS | $90K | $2K | $92K | 5.33% |
| ASSUREDPARTNERS3 | FOUR WESTBROOK CORPORATE CENTER SUITE 500 WESTCHESTER, IL 60154 | DEARBORN LIFE INSURANCE COMPANY | $4K | $1K | $5K | 20.39% |
| SOURCE ONE GROUP, LLC3 Filed as: SOURCE ONE BENEFITS, INC. | 206 SOUTH JEFFERSON STREET SUITE 200 CHICAGO, IL 60661 | DEARBORN LIFE INSURANCE COMPANY | $0 | $1K | $1K | 5.02% |
| ASSUREDPARTNERS3 | FOUR WESTBROOK CORPORATE CENTER SUITE 500 WESTCHESTER, IL 60154 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $954 | $0 | $954 | 8.39% |
| SOURCE ONE GROUP, LLC3 Filed as: SOURCE ONE BENEFITS, INC. | 206 SOUTH JEFFERSON STREET SUITE 200 CHICAGO, IL 60661 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $521 | $0 | $521 | 4.58% |
| AMERICAN WESTBROOK INS SERVICES LLC3 Filed as: AMERICAN WESTBROOK INS. SERVICE | FOUR WESTBROOK CORPORATE CENTER WESTCHESTER, IL 60154 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $87 | $0 | $87 | 0.77% |
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 | 195 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 196 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 271 | $1.7M |
| Dental | BLUECROSS BLUESHIELD OF ILLINOIS | 271 | $1.7M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 153 | $11K |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 193 | $26K |
| Prescription drug | BLUECROSS BLUESHIELD OF ILLINOIS | 271 | $1.7M |
| Other | DEARBORN LIFE INSURANCE COMPANY | 193 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 271 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.