| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANCE BENEFIT CONSULTANTS INC3 | 2630 FLOSSMOOR RD #101 FLOSSMOOR, IL 60422 | BLUECROSS BLUESHIELD OF ILLINOIS | $49K | $0 | $49K | 3.88% |
| ALLIANCE BENEFIT CONSULTANTS INC3 | 17732 OAK PARK AVE STE G TINLEY PARK, IL 60477 | PRINCIPAL LIFE INSURANCE COMPANY | $16K | $0 | $16K | 9.09% |
| DAWN M GONDA3 | 9405 BORMET DR STE 3 FLOSSMOOR, IL 60448 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $1K | $1K | 0.82% |
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 | 123 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 273 | $1.3M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 296 | $174K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 296 | $174K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 296 | $174K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 296 | $174K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 296 | $174K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 296 | — |
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.