| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 222 SOUTH RIVERSIDE PLAZA SUITE 900 CHICAGO, IL 60606 | UNITEDHEALTHCARE INSURANCE COMPANY | $475 | $65K | $65K | 5.28% |
| USI INSURANCE SERVICES LLC3 | 312 ELM STREET, 24TH FLOOR CINCINNATI, OH 45202 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $117 | $117 | 0.01% |
| USI INSURANCE SERVICES LLC3 | 222 SOUTH RIVERSIDE PLAZA SUITE 900 CHICAGO, IL 60606 | DELTA DENTAL PLAN OF ILLINOIS | $5K | $0 | $5K | 8.20% |
| MARIA J NOVOA3 Filed as: MARIA J. NOVOA | 26 COUR D ALENE PALOS HILLS, IL 60465 | AFLAC | $3K | $270 | $3K | 6.60% |
| MARCIN ZUREK3 | 210 DES PLAINES AVENUE, UNIT D FOREST PARK, IL 60130 | AFLAC | $1K | $56 | $2K | 2.96% |
| MJ INSURANCE3 Filed as: RUSSELL NOWAK AND VARIOUS AGENTS | 8009 VALLEY DRIVE PALOS HILLS, IL 60465 | AFLAC | $994 | $0 | $994 | 1.96% |
| RUBICON REGION LLC3 | 1862 KEYSTONE PLAZA SCHAUMBURG, IL 60193 | AFLAC | $442 | $56 | $498 | 0.98% |
| THERESA NETTO PHILLIPS3 Filed as: THERESA V. REDDING | 71 COUNTRY CLUB DRIVE BLOOMINGDALE, IL 60108 | AFLAC | $397 | $0 | $397 | 0.78% |
| EILEEN K. GALGANO3 | 16824 BLENHEIM WAY MINNETONKA, MN 55345 | AFLAC | $188 | $0 | $188 | 0.37% |
| MICHAEL ROBERT YURCZYK3 | 9616 WYOMING TERRACE SOUTH BLOOMINGTON, MN 55438 | AFLAC | $150 | $0 | $150 | 0.30% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $839 | $0 | $839 | 6.71% |
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 | 128 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 128 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 301 | $1.2M |
| Dental | DELTA DENTAL PLAN OF ILLINOIS | 166 | $66K |
| Vision | VISION SERVICE PLAN | 123 | $13K |
| Life insurance | UNITEDHEALTHCARE INSURANCE COMPANY | 301 | $1.2M |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 301 | $1.2M |
| Other(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 301 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 301 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.