| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W. GOLF RD., 11TH FLOOR ROLLING MEADOWS, IL 60008 | HEALTH CARE SERVICE CORPORATION | $10K | $3K | $13K | 0.53% |
| MARSH & MCLENNAN AGENCY LLC3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | HEALTH CARE SERVICE CORPORATION | $5K | $0 | $5K | 0.20% |
| MARSH & MCLENNAN AGENCY LLC3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 1.47% |
| JAMES J JUSTIC3 Filed as: JAMES D PANAGIOTIS | 4841 W. 105 PL., SUITE 106 OAK LAWN, IL 60453 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 1.36% |
| DANIEL S FOXEN3 | 76 TRENT COURT BURR RIDGE, IL 60527 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $793 | $0 | $793 | 0.91% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | P.O BOX 3009 ARLINGTON HEIGHTS, IL 60006 | DEARBORN LIFE INSURANCE COMPANY | $7K | $1K | $8K | 15.64% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 W. GOLF RD., 11TH FLOOR ROLLING MEADOWS, IL 60008 | EYEMED | $3K | $0 | $3K | 15.20% |
| ASSURANCE AGENCY LTD3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | EYEMED | $869 | $0 | $869 | 4.48% |
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 | 337 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 351 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH CARE SERVICE CORPORATION | 470 | $2.4M |
| Dental | HEALTH CARE SERVICE CORPORATION | 470 | $2.4M |
| Vision | EYEMED | 275 | $19K |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 337 | $53K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 306 | $88K |
| Other | DEARBORN LIFE INSURANCE COMPANY | 337 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 470 | — |
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.