| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 | 1750 EAST GOLF ROAD, SUITE 1100 SCHAUMBURG, IL 60173 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $2K | $0 | $2K | 3.71% |
| AMERICAN WESTBROOK INS SERVICES LLC3 Filed as: AMERICAN WESTBROOK INS. SERVICES | FOUR WESTBROOK CORPORATE CENTER SUITE 500 WESTCHESTER, IL 60154 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $803 | $0 | $803 | 1.19% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY, LTD. | 1750 EAST GOLF ROAD, SUITE 1100 SCHAUMBURG, IL 60173 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 8.97% |
| AMERICAN WESTBROOK INS SERVICES LLC3 Filed as: AMERICAN WESTBROOK INS. SERVICES | FOUR WESTBROOK CORPORATE CENTER SUITE 500 WESTCHESTER, IL 60154 | PRINCIPAL LIFE INSURANCE COMPANY | $930 | $0 | $930 | 4.49% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY, LTD. | 1750 EAST GOLF ROAD, SUITE 140 CHICAGO, IL 60173 | VISION SERVICE PLAN | $379 | $0 | $379 | 5.37% |
| AMERICAN WESTBROOK INS SERVICES LLC3 Filed as: AMERICAN WESTBROOK INS. SERVICES | FOUR WESTBROOK CORPORATE CENTER SUITE 500 WESTCHESTER, IL 60154 | VISION SERVICE PLAN | $224 | $0 | $224 | 3.17% |
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 | 143 | 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) | 143 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | BLUE CROSS BLUE SHIELD OF ILLINOIS | 310 | $67K |
| Vision | VISION SERVICE PLAN | 74 | $7K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 165 | $21K |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 165 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 310 | — |
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.