| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N. MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 7.74% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY LTD. | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | ONEAMERICA | $4K | — | $4K | 13.50% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 20 N. MARTINGALE RD., STE 100 SCHAUMBURG, IL 60173 | COLONIAL LIFE AND ACCIDENT INS CO | $288 | — | $288 | 11.38% |
| REBECCA STERNBERG3 | 374 MILFORD RD DEERFIELD, IL 60015 | COLONIAL LIFE AND ACCIDENT INS CO | $71 | — | $71 | 2.81% |
| NORMAC SOLUTIONS INC3 Filed as: NORMAC SOLUTIONS INC. | 451 HOPKINS ROAD TOWNVILLE, SC 29689 | COLONIAL LIFE AND ACCIDENT INS CO | $65 | — | $65 | 2.57% |
| ELAISIUS BONNER3 | 974 ROSEFILED LANE AURORA, IL 60504 | COLONIAL LIFE AND ACCIDENT INS CO | $32 | $29 | $61 | 2.41% |
| MICHAEL BLOCK3 | 16619 S PINECREEK DRIVE LOCKPORT, IL 60441 | COLONIAL LIFE AND ACCIDENT INS CO | $8 | — | $8 | 0.32% |
| DAVID TODD WEINSTEIN3 | 222 N. COLUMBUS DR. CHICAGO, IL 60601 | COLONIAL LIFE AND ACCIDENT INS CO | $6 | — | $6 | 0.24% |
| JOSHUA T JONES3 | 25 GARFIELD LN STREAMWOOD, IL 60107 | COLONIAL LIFE AND ACCIDENT INS CO | $3 | — | $3 | 0.12% |
| JANTELLE LAVONNE BONNER3 | 974 ROSEFIELD LANE AURORA, IL 60504 | COLONIAL LIFE AND ACCIDENT INS CO | $1 | $1 | $2 | 0.08% |
| DAVID J MCCLELLAN3 Filed as: DAVID GORDON EARL | 289 REDWOOD AVE ELK GROVE VILLAGE, IL 60007 | COLONIAL LIFE AND ACCIDENT INS CO | $1 | — | $1 | 0.04% |
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 | 117 | 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) | 119 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 84 | $58K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 84 | $58K |
| Life insurance(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 117 | $84K |
| Short-term disability(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 117 | $84K |
| Long-term disability(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 117 | $84K |
| Other(3 contracts, 3 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 117 | $87K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 117 | — |
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.