| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 55 SHUMAN BLVD STE 900 NAPERVILLE, IL 60563 | BLUECROSS BLUESHIELD OF ILLINOIS | $58K | — | $58K | 4.04% |
| ACRISURE LLC3 | 55 SHUMAN BLVD STE 900 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $559 | $3K | 5.49% |
| ACRISURE LLC3 | 55 SHUMAN BLVD STE 900 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $757 | $4K | 10.42% |
| ACRISURE LLC3 | 55 SHUMAN BLVD STE 900 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $334 | $2K | 11.77% |
| ACRISURE LLC3 | 55 SHUMAN BLVD STE 900 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $330 | $3K | 17.07% |
| ACRISURE LLC3 | 55 SHUMAN BLVD STE 900 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $340 | $3K | 16.97% |
| ACRISURE LLC3 | 55 SHUMAN BLVD STE 900 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $776 | $161 | $937 | 10.79% |
| ACRISURE LLC3 | 55 SHUMAN BOULEVARD SUITE 900 NAPERVILLE, IL 60563 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $947 | $101 | $1K | 14.39% |
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 | 213 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 213 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 240 | $1.4M |
| Dental(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 107 | $67K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 121 | $9K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 213 | $35K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 213 | $42K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 39 | $16K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 213 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 240 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.