| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CROWN RISK MANAGEMENT, LLC3 Filed as: LAMBENT RISK MANAGEMENT SERVICES | 1 N LASALLE ST 35TH FLOOR CHICAGO, IL 60602 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $79K | — | $79K | 4.88% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: LAMBENT RISK MANAGEMENT SERVICES | 1 N LASALLE ST 35TH FLOOR CHICAGO, IL 60602 | UNITED HEALTHCARE INSURANCE COMPANY | $6K | — | $6K | 4.88% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: LAMBENT RISK MANAGEMENT SERVICES | 1 N LASALLE ST 35TH FLOOR CHICAGO, IL 60602 | UNUM | $6K | — | $6K | 5.90% |
| HENRY J SAMAAN3 Filed as: HENRY JACOB SAMAAN | 19W152 21ST PL LOMARD, IL 60148 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $10K | $17K | $27K | 31.57% |
| MARK D BARBIER3 Filed as: MARK BARBIER | 802 DEER TRAIL LN OAKBROOK, IL 60523 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $11K | $15K | 17.60% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: LAMBENT RISK MANAGEMENT SERVICES | 33 N LASALLE ST CHICAGO, IL 60602 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $14K | — | $14K | 17.26% |
| ROBERT CZERWINSKI3 | 3512 STONECREEK JOLIET, IL 60435 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $3K | $5K | 5.58% |
| GERALD A GREENEN3 | ONE TOWER LN OAKBROOK TERRACE LN, IL 60181 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $525 | $4K | 4.40% |
| CORCORAN & HOYT LLC3 | 12505 BRONCO DRIVE TAMPA, FL 33624 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $671 | $2K | 2.64% |
| STEPHANIE R KLADIS3 | 7517 W HANOVER ST SUMMIT, IL 60501 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $197 | $1K | 1.72% |
| DEBRA POCZATKO3 Filed as: DEBRA R POCZATKO | 14466 S ELIZABETH LN HOMER GLEN, IL 60491 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 1.41% |
| ANTHONY VESTAL3 | 15512 RIDGEFIELD DR MANHATTAN, IL 60442 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $362 | — | $362 | 0.43% |
| RUSSELL R DIXON3 Filed as: RUSSELL R DIXON LLC | P.O. BOX 27 WHEATON, IL 60187 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $352 | — | $352 | 0.42% |
| NICOLAS BERLANGA CORONADO3 | 971 N ELMWOOD DR AURORA, IL 60506 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $145 | — | $145 | 0.17% |
| FELTER INC3 | 5403 COMMONWEALTH AVE WESTERN SPRINGS, IL 60558 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $26 | $6 | $32 | 0.04% |
| MONICA L LEIVA3 | 556 N ARTESIAN AVE CHICAGO, IL 60612 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 0.03% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: LAMBENT RISK MANAGEMENT SERVICES | 1 N LASALLE ST 35TH FLOOR CHICAGO, IL 60602 | METLIFE INSURANCE | $628 | $0 | $628 | 4.89% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: LAMBENT RISK MANAGEMENT SERVICES | 1 N LASALLE ST 35TH FLOOR CHICAGO, IL 60602 | FIDELITY SECURITY LIFE | $595 | — | $595 | 4.88% |
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 | 332 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 332 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 332 | $1.8M |
| Dental(2 contracts, 2 carriers) | UNUM | 259 | $106K |
| Vision | FIDELITY SECURITY LIFE | 138 | $12K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 266 | $97K |
| Long-term disability | METLIFE INSURANCE | 256 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 332 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.