| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY LTD. | 1750 E GOLF ROAD SCHAUMBURG, IL 60173 | BLUECROSS BLUESHIELD OF ILLINOIS | $40K | $3K | $43K | 4.55% |
| ASSURANCE AGENCY LTD3 | 1750 EAST GOLF ROAD OSAGE BEACH, IL 60173 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | $2K | $8K | 12.26% |
| ASSURANCE AGENCY LTD3 | 1750 E GOLF ROAD SCHAUMBURG, IL 60173 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | $1K | $5K | 19.91% |
| ASSURANCE AGENCY LTD3 | 1750 E GOLF ROAD SCHAUMBURG, IL 60173 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $555 | $3K | 18.31% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E. GOLF ROAD SCHAUMBURG, IL 60173 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $1 | $3K | 20.01% |
| ASSURANCE AGENCY LTD3 | 1750 E GOLF ROAD SCHAUMBURG, IL 60173 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | $584 | $2K | 19.97% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY, LTD. | 1750 E GOLF RD STE 140 CHICAGO, IL 60173 | VISION SERVICE PLAN | $697 | — | $697 | 7.79% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY, LTD | 1750 E GOLF ROAD SCHAUMBURG, IL 60173 | CONTINENTAL AMERICAN INSURANCE COMPANY | $773 | — | $773 | 9.21% |
| JOY A HOWARD3 | 1491 GINGER LANE NEW LENOX, IL 60451 | CONTINENTAL AMERICAN INSURANCE COMPANY | $232 | — | $232 | 2.77% |
| 22 INSURANCE GROUP INC3 | 22385 MISTY FALLS CIRCLE FRANKFORT, IL 60423 | CONTINENTAL AMERICAN INSURANCE COMPANY | $223 | — | $223 | 2.66% |
| JEFFREY LYNN LAMBERT3 Filed as: JEFFREY L LAMBERT | 15419 W 127TH ST LEMONT, IL 60439 | CONTINENTAL AMERICAN INSURANCE COMPANY | $128 | — | $128 | 1.53% |
| ORLANDO R DOBRINCU3 | 837 LINDEN CIRCLE HOFFMAN ESTATES, IL 60159 | CONTINENTAL AMERICAN INSURANCE COMPANY | $120 | — | $120 | 1.43% |
| MONICA L LEIVA3 | 556 N ARTESIAN CHICAGO, IL 60612 | CONTINENTAL AMERICAN INSURANCE COMPANY | $59 | — | $59 | 0.70% |
| SCOTT A HOWARD3 | 1491 GINGER LANE NEW LENOX, IL 60451 | CONTINENTAL AMERICAN INSURANCE COMPANY | $50 | — | $50 | 0.60% |
| CHAD L NELSON3 | 490 EAST ROOSEVELT ROAD SUITE 203 WEST CHICAGO, IL 60185 | CONTINENTAL AMERICAN INSURANCE COMPANY | $47 | — | $47 | 0.56% |
| STEPHEN KELLS3 | 514 MAYFAIR COURT GERMANTOWN HILLS, IL 61568 | CONTINENTAL AMERICAN INSURANCE COMPANY | $43 | — | $43 | 0.51% |
| NORMA HUERTA3 | 14420 S ALBANY AVE POSEN, IL 60469 | CONTINENTAL AMERICAN INSURANCE COMPANY | $31 | — | $31 | 0.37% |
| HENRY J SAMAAN3 | 19W152 21ST PLACE LOMBARD, IL 60148 | CONTINENTAL AMERICAN INSURANCE COMPANY | $30 | — | $30 | 0.36% |
| OKSAN K PILAFAS3 Filed as: OKSAN PILAFAS | 4415 W HARRISON ST STE 503 HILLSIDE, IL 60162 | CONTINENTAL AMERICAN INSURANCE COMPANY | $16 | — | $16 | 0.19% |
| KNUTE NELSON3 Filed as: KNUTE T NELSON | 2270 BURTON AVE KRONENWETTER, WI 54455 | CONTINENTAL AMERICAN INSURANCE COMPANY | $14 | — | $14 | 0.17% |
| SCHWARTZ BENEFIT SERVICES INC3 | 500 WEST MADISON SUITE 2700 CHICAGO, IL 60661 | CONTINENTAL AMERICAN INSURANCE COMPANY | $14 | — | $14 | 0.17% |
| SCOTT LYDEN3 Filed as: SCOTT F LYDEN | 1284 ROSEGATE CT AURORA, IL 60504 | CONTINENTAL AMERICAN INSURANCE COMPANY | $12 | — | $12 | 0.14% |
| JOHN H VRATSINAS3 | 1142 WEST MADISON #305 CHICAGO, IL 60607 | CONTINENTAL AMERICAN INSURANCE COMPANY | $8 | — | $8 | 0.10% |
| TIMOTHY B ASBY3 | 9247 N MERIDIAN ST STE 205 INDIANAPOLIS, IN 46260 | CONTINENTAL AMERICAN INSURANCE COMPANY | $8 | — | $8 | 0.10% |
| ELIZABETH A LENZO3 | 349 E CALIFORNIA BLVD PASADENA, CA 91106 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2 | — | $2 | 0.02% |
| ROCKWELL & ASSOCIATES3 Filed as: ROCKWELL & ASSOCIATES LTD | 303 W ERIE STREET SUITE 400 CHICAGO, IL 60654 | AFLAC | $74 | — | $74 | 2.15% |
| NASCA & ASSOCIATES3 Filed as: NASCA AND ASSOCIATES LTD | 303 W ERIE ST STE 400 CHICAGO, IL 60654 | AFLAC | $51 | — | $51 | 1.48% |
| THE SEGAL COMPANY3 Filed as: LAURA SEGEL | 360 W ILLINOIS STREET, APT. 9A CHICAGO, IL 60654 | AFLAC | $43 | — | $43 | 1.25% |
| KATHERINE STEPHANI3 | 300 WALL ST UNIT 301 SAINT PAUL, MN 55101 | AFLAC | $41 | — | $41 | 1.19% |
| MARK D BARBIER3 Filed as: MARK BARBIER | 802 DEER TRAIL LANE OAK BROOK, IL 60523 | AFLAC | $13 | — | $13 | 0.38% |
| MATT IBACH3 | 233 E 13TH ST., APT. 2302 CHICAGO, IL 60605 | AFLAC | $11 | — | $11 | 0.32% |
| TODD DEVOSS3 | 321 N CLARK STREET STE 625 CHICAGO, IL 60654 | AFLAC | $1 | — | $1 | 0.03% |
| JOSEPH P CALARCO3 Filed as: JOSEPH NASCA | 28081 W MAPLE AVE BARRINGTON, IL 60010 | AFLAC | $1 | — | $1 | 0.03% |
| ASSURANCE AGENCY LTD3 | 1750 E GOLF ROAD SCHAUMBURG, IL 60173 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $348 | $214 | $562 | 24.25% |
| ASSURANCE AGENCY LTD3 | 1750 E GOLF ROAD SCHAUMBURG, IL 60173 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $132 | $44 | $176 | 20.07% |
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 | 158 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 158 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 190 | $954K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 107 | $67K |
| Vision | VISION SERVICE PLAN | 74 | $9K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 158 | $2K |
| Short-term disability(3 contracts, 3 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 158 | $37K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 158 | $17K |
| Other(5 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 158 | $46K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 190 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
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.