| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: CONNOR & GALLAGHER BENEFITS SERVICE | — | BLUECROSS BLUESHIELD OF ILLINOIS | $58K | $918 | $59K | 3.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: CONNOR & GALLAGHER BENEFITS SERVICE | 750 WARRENVILLE ROAD SUITE 400 LISLE, IL 60532 | BLUECROSS BLUESHIELD OF ILLINOIS | — | $7 | $7 | 0.00% |
| TERRAZZO & MARBLE SUPPLY CO.3 | 77 SOUTH WHEELING ROAD WHEELING, IL 60090 | BLUECROSS BLUESHIELD OF ILLINOIS | — | $3 | $3 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: CONNOR & GALLAGHER BENEFITS SE | 750 WARRENVILLE ROAD SUITE 400 LISLE, IL 60532 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | $1K | $9K | 7.75% |
| WATCHTOWER BENEFITS, LLC3 Filed as: WATCHTOWER BENEFITS LLC | 2734 NORTH MILDRED AVENUE #3 CHICAGO, IL 60618 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 3.91% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: CONNOR & GALLAGHER BENEFIT SERVS IN | 750 WARRENVILLE ROAD SUITE 400 LISLE, IL 60532 | DEARBORN LIFE INSURANCE COMPANY | $3K | — | $3K | 10.89% |
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 | 126 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 127 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 185 | $1.5M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 130 | $121K |
| Vision | DEARBORN LIFE INSURANCE COMPANY | 125 | $28K |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 125 | $28K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 130 | $121K |
| Other | DEARBORN LIFE INSURANCE COMPANY | 125 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 185 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.