| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 | 1750 E GOLF RD OSAGE BEACH, IL 60173 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $13K | $6K | $19K | 15.70% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E GOLF RD SCHAUMBURG, IL 60173 | COLONIAL LIFE AND ACCIDENT INS CO | $295 | $50 | $345 | 16.48% |
| D T WEINSTEIN3 | 601 W JACKSON BLVD, UNIT 912 CHICAGO, IL 60661 | COLONIAL LIFE AND ACCIDENT INS CO | $158 | $162 | $320 | 15.29% |
| M BLOCK3 | 16619 S. PINECREEK DR LOCKPORT, IL 60441 | COLONIAL LIFE AND ACCIDENT INS CO | $227 | $91 | $318 | 15.19% |
| R STERNBERG3 | 374 MILFORD RD DEERFIELD, IL 60015 | COLONIAL LIFE AND ACCIDENT INS CO | $160 | $20 | $180 | 8.60% |
| J T JONES3 | 25 GARFIELD LN STREAMWOOD, IL 60107 | COLONIAL LIFE AND ACCIDENT INS CO | $1 | $2 | $3 | 0.14% |
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 | 173 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 175 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 173 | $123K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 173 | $123K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 173 | $123K |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 173 | $123K |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 173 | $123K |
| Other(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 173 | $125K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 173 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.