| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 55 SHUMAN BLVD STE 900 NAPERVILLE, IL 60563 | BLUECROSS BLUESHIELD OF ILLINOIS | $60K | $3K | $64K | 4.02% |
| ACRISURE LLC3 | 55 SHUMAN BLVD STE 900 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 6.90% |
| ACRISURE LLC3 | 55 SHUMAN BLVD STE 900 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $3K | $7K | 13.68% |
| ACRISURE LLC3 | 55 SHUMAN BLVD STE 900 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $4K | 15.68% |
| ACRISURE LLC3 | 55 SHUMAN BLVD STE 900 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 20.12% |
| ACRISURE LLC3 | 55 SHUMAN BLVD STE 900 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 21.04% |
| ACRISURE LLC3 | 55 SHUMAN BLVD STE 900 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $880 | $588 | $1K | 14.52% |
| ACRISURE LLC3 | 55 SHUMAN BOULEVARD SUITE 900 NAPERVILLE, IL 60563 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | $96 | $1K | 14.11% |
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 | 235 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 235 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 229 | $1.6M |
| Dental(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 112 | $82K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 124 | $10K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 235 | $40K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 235 | $51K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 40 | $18K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 235 | $40K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 235 | — |
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.