| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | BLUECROSS BLUESHIELD OF ILLINOIS | $65K | $3K | $68K | 2.14% |
| HUNTINGTON INSURANCE INC3 | 221 S CHURCH ST BOWLING GREEN, OH 43402 | BLUECROSS BLUESHIELD OF ILLINOIS | $13K | — | $13K | 0.41% |
| ERIC S BIRKENSTEIN3 Filed as: ERIC BIRKENSTEIN | 892 THORNAPPLE LN GLENCOE, IL 60022 | STANDARD INSURANCE COMPANY | $8K | — | $8K | 15.00% |
| ROCKWELL & ASSOCIATES3 Filed as: ROCKWELL & ASSOCIATES LTD | 303 W ERIE ST STE 400 CHICAGO, IL 60654 | AFLAC | $1K | $43 | $1K | 3.02% |
| NASCA & ASSOCIATES3 Filed as: NASCA AND ASSOCIATES LTD | 303 W ERIE ST STE 400 CHICAGO, IL 60654 | AFLAC | $607 | $29 | $636 | 1.52% |
| JOHN HERNANDEZ3 | 3142 S LITUANICA AVE CHICAGO, IL 60608 | AFLAC | $411 | — | $411 | 0.98% |
| THE SEGAL COMPANY3 Filed as: LAURA SEGEL | 360 W ILLINOIS ST APT 9A CHICAGO, IL 60654 | AFLAC | $405 | — | $405 | 0.97% |
| JORGE ALEJANDRO MONTEMAYOR3 Filed as: JORGE H CASTELLANOS | 7441 FIGURA DR JUSTICE, IL 60458 | AFLAC | $214 | — | $214 | 0.51% |
| CORY DUKES3 | 2613 W EVERGREEN AVE APT 3F CHICAGO, IL 60622 | AFLAC | $104 | $61 | $165 | 0.39% |
| ORA ANDERSON3 | 303 W ERIE ST STE 400 CHICAGO, IL 60654 | AFLAC | $142 | — | $142 | 0.34% |
| CHRISTOPHER RYAN CORDON3 | 1080 BLACKHAWK DR ELGIN, IL 60120 | AFLAC | $93 | — | $93 | 0.22% |
| MARK D BARBIER3 | 23 CROYDON LN OAK BROOK, IL 60523 | AFLAC | $91 | — | $91 | 0.22% |
| ERIC BROGAN3 Filed as: ERIC SPENGEL | 1005 WESCOTT DR FORT WAYNE, IN 46818 | AFLAC | $70 | — | $70 | 0.17% |
| TODD DEVOSS3 Filed as: TODD C DEVOSS | 321 N CLARK ST STE 625 CHICAGO, IL 60654 | AFLAC | $54 | — | $54 | 0.13% |
| SUSAN C BRIMHALL3 | PO BOX 336 SMITHS STATION, AL 36877 | AFLAC | $52 | — | $52 | 0.12% |
| JENNIFER R GLASSBERG3 | 307 LIVE OAK LN BOYNTON BEACH, FL 33436 | AFLAC | $44 | — | $44 | 0.11% |
| SANTIAGO & ASSOCIATES LLC3 | 950 W NORTON AVE STE 201 MUSKEGON, MI 49441 | AFLAC | $40 | — | $40 | 0.10% |
| ANDREW CASPERSON3 Filed as: ANDREW W CASPERSON AND ASSOC LLC | 303 W ERIE ST STE 400 CHICAGO, IL 60654 | AFLAC | $29 | $11 | $40 | 0.10% |
| ALFREDO MALDONADO JR3 | 2837 HOME AVE BERWYN, IL 60402 | AFLAC | $15 | $17 | $32 | 0.08% |
| MATT S IBACH3 | 1107 OXFORD ST DOWNERS GROVE, IL 60516 | AFLAC | $30 | — | $30 | 0.07% |
| DANIEL A MARINEZ3 Filed as: DANIEL MARINEZ | 303 W ERIE ST STE 400 CHICAGO, IL 60654 | AFLAC | $28 | — | $28 | 0.07% |
| JEFFERY A BILL3 | 1700 S MORGAN ST UNIT 4 CHICAGO, IL 60608 | AFLAC | $20 | — | $20 | 0.05% |
| HELENE HENDRICKSON3 | 1658 CAMDEN AVE APT 108 LOS ANGELES, CA 90025 | AFLAC | $19 | — | $19 | 0.05% |
| K HARRIS & ASSOCIATES, LLC3 Filed as: K HARRIS & ASSOCIATES LLC | 950 W NORTON AVE STE 201 MUSKEGON, MI 49441 | AFLAC | $11 | — | $11 | 0.03% |
| JOSEPH A NASCA3 | 28081 W MAPLE AVE BARRINGTON, IL 60010 | AFLAC | $11 | — | $11 | 0.03% |
| ABELARDO RODRIGUEZ3 | 303 W ERIE ST STE 400 CHICAGO, IL 60654 | AFLAC | $10 | — | $10 | 0.02% |
| ADAM H MICHAELS3 Filed as: ADAM H MICHAELS & ASSOC LTD | 2922 CORDA LN LOS ANGELES, CA 90049 | AFLAC | $9 | — | $9 | 0.02% |
| TINA M LASSUY3 | 3021 45TH ST MOLINE, IL 61265 | AFLAC | $8 | — | $8 | 0.02% |
| KIMBERLY DEWINTER3 Filed as: KIMBERLY A DEWINTER | 1523 47TH AVE STE 3 MOLINE, IL 61265 | AFLAC | $8 | — | $8 | 0.02% |
| KIMBERLY A AIKINS3 | 606 19TH ST MOLINE, IL 61265 | AFLAC | $6 | — | $6 | 0.01% |
| CHRISTINE L BREWSTER3 | 1312 FARLEY LN CHAMPAIGN, IL 61265 | AFLAC | $5 | — | $5 | 0.01% |
| WILLIAM T GANT3 | 1355 B LYNNFIELD RD STE 259 MEMPHIS, TN 38119 | AFLAC | $3 | — | $3 | 0.01% |
| MARC D BARNES3 | 148 FOSSIL LAKE CT WILMINGTON, IL 60481 | AFLAC | $2 | — | $2 | 0.00% |
| ERIC S BIRKENSTEIN3 Filed as: ERIC BIRKENSTEIN | 892 THORNAPPLE LN GLENCOE, IL 60022 | STANDARD INSURANCE COMPANY | $5K | — | $5K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | VISION SERVICE PLAN | $1K | — | $1K | 4.78% |
| HUNTINGTON INSURANCE INC3 Filed as: HUNTINGTON INSURANCE, INC | 221 S CHURCH ST BOWLING GREEN, OH 43402 | VISION SERVICE PLAN | $119 | — | $119 | 0.55% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | DELTA DENTAL OF ILLINOIS | $1K | — | $1K | 11.08% |
| HUNTINGTON INSURANCE INC3 | 221 S CHURCH ST BOWLING GREEN, OH 43402 | DELTA DENTAL OF ILLINOIS | $136 | — | $136 | 1.03% |
| ERIC S BIRKENSTEIN3 Filed as: ERIC S BIRKENSTIEN | 892 THORNAPPLE LN GLENCOE, IL 60022 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 20.00% |
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 | 319 | 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) | 319 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 504 | $3.2M |
| Dental | DELTA DENTAL OF ILLINOIS | 271 | $13K |
| Vision | VISION SERVICE PLAN | 184 | $22K |
| Life insurance | STANDARD INSURANCE COMPANY | 313 | $56K |
| Long-term disability | STANDARD INSURANCE COMPANY | 313 | $36K |
| Prescription drug | BLUECROSS BLUESHIELD OF ILLINOIS | 504 | $3.2M |
| Other(2 contracts, 2 carriers) | AFLAC | 81 | $48K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 504 | — |
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.