| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 | 4350 WEAVER PARKWAY WARRENVILLE, IL 60555 | BLUECROSS BLUESHIELD OF ILLINOIS | $85K | $5K | $90K | 5.67% |
| ASSUREDPARTNERS3 | 4350 WEAVER PARKWAY WARRENVILLE, IL 60555 | DEARBORN LIFE INSURANCE COMPANY | $9K | $0 | $9K | 14.78% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: INSENTIAL, INC. | 206 SOUTH JEFFERSON, SUITE 200 CHICAGO, IL 60661 | DEARBORN LIFE INSURANCE COMPANY | $0 | $1K | $1K | 1.99% |
| ASSUREDPARTNERS3 | 4 WESTBROOK CORPORATE CENTER SUITE 500 WESTCHESTER, IL 60154 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $524 | $0 | $524 | 5.84% |
| SOURCE ONE GROUP, LLC3 Filed as: SOURCE ONE BENEFITS, INC. | 206 SOUTH JEFFERSON, SUITE 200 CHICAGO, IL 60661 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $427 | $0 | $427 | 4.76% |
| ASSUREDPARTNERS3 | 4350 WEAVER PARKWAY WARRENVILLE, IL 60555 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $330 | $0 | $330 | 3.68% |
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 | 204 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 210 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 252 | $1.6M |
| Dental | BLUECROSS BLUESHIELD OF ILLINOIS | 252 | $1.6M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 152 | $9K |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 179 | $58K |
| Short-term disability | DEARBORN LIFE INSURANCE COMPANY | 179 | $58K |
| Prescription drug | BLUECROSS BLUESHIELD OF ILLINOIS | 252 | $1.6M |
| Other | DEARBORN LIFE INSURANCE COMPANY | 179 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 252 | — |
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.