| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MESIROW INSURANCE SERVICES INC3 | 353 NORTH CLARK STREET CHICAGO, IL 60654 | UNITEDHEALTHCARE INSURANCE COMPANY | $443 | $30K | $30K | 3.53% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INS SERVICES INC | 353 NORTH CLARK STREET CHICAGO, IL 60654 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $2K | $7K | 19.72% |
| MESIROW INSURANCE SERVICES INC3 | 353 NORTH CLARK STREET CHICAGO, ID 60654 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $425 | $4K | 16.44% |
| CHRISTOPHER RYAN CORDON3 | 1080 BLACKHAWK DRIVE ELGIN, IL 60120 | AFLAC | $1K | $230 | $2K | 7.85% |
| JASON A ROBERTS3 | 2200 OAKTON STREET APARTMENT 2 PARK RIDGE, IL 60068 | AFLAC | $496 | — | $496 | 2.50% |
| ELAINE A WRINKLE3 | 404 TICKSEED AVENUE SAVOY, IL 61874 | AFLAC | $320 | — | $320 | 1.61% |
| NASCA & ASSOCIATES3 Filed as: NASCA AND ASSOCIATES LTD | 303 WEST ERIE STREET SUITE 400 CHICAGO, IL 60654 | AFLAC | $277 | $27 | $304 | 1.53% |
| SHARYL K BATHE3 | 120 SOUTH 8TH STREET MATTOON, IL 61938 | AFLAC | $125 | $13 | $138 | 0.70% |
| MARK D BARBIER3 | 802 DEER TRAIL LANE OAK BROOK, IL 60523 | AFLAC | $103 | $27 | $130 | 0.65% |
| MICHAEL RAY ROBINS3 | 3812 NANTUCKET DRIVE PLANO, TX 75023 | AFLAC | $89 | $13 | $102 | 0.51% |
| JENNIFER R GLASSBERG3 | 304 INDIAN TRACE 820 WESTON, FL 33326 | AFLAC | $57 | — | $57 | 0.29% |
| TRAVIS COCKBURN3 Filed as: TRAVIS J COCKBURN | 402 NORTH MAIN STREET BENTON, IL 62812 | AFLAC | $37 | $13 | $50 | 0.25% |
| JANETTE V HARRIS3 | 668 BRIDGEVIEW BAY LANE MUSKEGON, MI 49441 | AFLAC | $12 | — | $12 | 0.06% |
| ANGELA R SCHIEK3 | 953 WILLOW LANE SLEEPY HOLLOW, IL 60118 | AFLAC | $10 | — | $10 | 0.05% |
| JEANETTE V HARRIS3 | 303 WEST ERIE STREET SUITE 400 CHICAGO, IL 60654 | AFLAC | $9 | — | $9 | 0.05% |
| THE SEGAL COMPANY3 Filed as: LAURA SEGEL | 360 WEST ILLINOIS STREET APARTMENT 9A CHICAGO, IL 60654 | AFLAC | $3 | — | $3 | 0.02% |
| CHRISTOPHER RYAN CORDON3 | 1080 BLACKHAWK DRIVE ELGIN, IL 60120 | AFLAC | $278 | — | $278 | 3.28% |
| JENNIFER R GLASSBERG3 | 304 INDIAN TRACE 820 WESTON, FL 33326 | AFLAC | $139 | — | $139 | 1.64% |
| JASON A ROBERTS3 | 2200 OAKTON STREET APARTMENT 2 PARK RIDGE, IL 60068 | AFLAC | $129 | — | $129 | 1.52% |
| NASCA & ASSOCIATES3 Filed as: NASCA AND ASSOCIATES LTD | 303 WEST ERIE STREET SUITE 400 CHICAGO, IL 60654 | AFLAC | $127 | — | $127 | 1.50% |
| MARK D BARBIER3 | 802 DEER TRAIL LN OAK BROOK, IL 60523 | AFLAC | $58 | — | $58 | 0.68% |
| ANGELA R SCHIEK3 | 953 WILLOW LANE SLEEPY HOLLOW, IL 60118 | AFLAC | $30 | — | $30 | 0.35% |
| JEANETTE V HARRIS3 | 668 BRIDGEVIEW BAY LANE MUSKEGON, MI 49441 | AFLAC | $27 | — | $27 | 0.32% |
| JEANETTE V HARRIS3 | 303 WEST ERIE STREET SUITE 400 CHICAGO, IL 60654 | AFLAC | $18 | — | $18 | 0.21% |
| MESIROW INSURANCE SERVICES INC3 | 353 NORTH CLARK STREET CHICAGO, IL 60654 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $141 | $1K | 16.75% |
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 | 122 | 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) | 123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 140 | $852K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 82 | $37K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 123 | $22K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 123 | $22K |
| Other(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 123 | $59K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 140 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.