| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J GALLAGHER RISK MGMT | 2850 GOLF RD ROLLING MEADOWS, IL 60008 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $114K | — | $114K | 5.09% |
| FINANCIAL SERVICE MANAGERS, INC.3 Filed as: FINANCIAL SERVICE MANAGERS | 101 BURR RIDGE PKWY WILLOWBROOK, IL 60527 | GUARDIAN | $2K | $2K | $4K | 2.52% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 12750 MERIT DR STE 1000 DALLAS, TX 75251 | GUARDIAN | $4K | — | $4K | 2.18% |
| HENRY J SAMAAN3 Filed as: HENRY JACOB SAMAAN | 19W152 21ST PL LOMARD, IL 60148 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $5K | $12K | 7.87% |
| GERALD A GREENEN3 | 1212 S NAPER NAPERVILLE, IL 60540 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $1K | $5K | 3.22% |
| DEBRA POCZATKO3 Filed as: DEBRA RENNE BARCH | 14466 S ELIZABETH LN HOMER GLEN, IL 60491 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $1K | $5K | 3.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 GOLF RD ROLLING MEADOWS, IL 60008 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $149 | $4K | 2.81% |
| J J DOORHY BENEFITS GROUP3 Filed as: JJ DOORHY AND ASSOCIATES | 101 BURR RIDGE PKWY BURR RIDGE, IL 60527 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 2.25% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: LAMBENT RISK MANAGEMENT SERVICES | 33 N LASALLE ST CHICAGO, IL 60602 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 0.81% |
| ANTHONY VESTAL3 | 15512 RIDGEFIELD DR MANHATTAN, IL 60442 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $469 | $78 | $547 | 0.36% |
| CORCORAN & HOYT LLC3 | 12505 BRONCO DRIVE TAMPA, FL 33624 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $271 | — | $271 | 0.18% |
| ROBERT CZERWINSKI3 | 3512 STONECREEK JOLIET, IL 60435 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $250 | — | $250 | 0.17% |
| MONICA L LEIVA3 | 556 N ARTESIAN AVE CHICAGO, IL 60612 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $159 | — | $159 | 0.11% |
| MARK D BARBIER3 Filed as: MARK BARBIER | 23 CROYDON LA OAKBROOK, IL 60523 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $84 | — | $84 | 0.06% |
| GSD KATIE K MILLER INC3 Filed as: GSD KATIE MILLER INC | 30 SOUTHFORK DR DADEVILLE, AL 36853 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $31 | — | $31 | 0.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J GALLAGHER RISK MGMT | 2850 GOLF RD ROLLING MEADOWS, IL 60008 | FIDELITY SECURITY LIFE | $890 | — | $890 | 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 | 324 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 324 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 263 | $2.2M |
| Dental | GUARDIAN | 324 | $161K |
| Vision | FIDELITY SECURITY LIFE | 169 | $18K |
| Life insurance | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 284 | $150K |
| Long-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 284 | $150K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 324 | — |
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.