| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIED BENEFIT SYSTEMS, LLC3 Filed as: ALLIED BENEFIT SYSTEMS, INC. | 200 WEST ADAMS STREET SUITE 500 CHICAGO, IL 60606 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $15K | — | $15K | 10.00% |
| DEPLOYANT ADVISORS3 | — | VISION SERVICE PLAN | $1K | — | $1K | 5.13% |
| DEPLOYANT ADVISORS3 Filed as: DEPLOYANT ADVISORS LLC | 1350 E. TOUHY AVENUE DES PLAINES, IL 60018 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 7.02% |
| ROBERT CZERWINSKI3 | 3512 STONE CREEK JOLIET, IL 60435 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $466 | $783 | $1K | 5.68% |
| FELTER INC3 Filed as: FELTER INC. | 5403 COMMONWEALTH AVENUE WESTERN SPRINGS, IL 60558 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $877 | $159 | $1K | 4.71% |
| HOWARD HOROWITZ3 | 2610 ALCOTT STREET CARMEL, IN 46032 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $373 | $134 | $507 | 2.31% |
| MICHAEL A SMITH3 Filed as: MICHAEL SMITH | 100 E 14TH STREET #3205 CHICAGO, IL 60605 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $354 | — | $354 | 1.61% |
| JORGE CASTELLANOS3 | 7441 FIGURA DRIVE JUSTICE, IL 60458 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $40 | $4 | $44 | 0.20% |
| PARRISH J PEACHEE3 Filed as: PARRISH PEACHEE | 109 N. UNION STREET WESTFIELD, IN 46074 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.08% |
| DAVID TODD WEINSTEIN3 | 601 W. JACKSON BLVD UNIT 912 CHICAGO, IL 60661 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $1 | $14 | 0.06% |
| JOSHUA JONES3 | 25 GARFIELD LANE STREAMWOOD, IL 60107 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | $2 | $14 | 0.06% |
| MICHAEL BLOCK3 | 16619 S. PINECREEK DRIVE LOCKPORT, IL 60441 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 PPO | Insurance services Service code 23 | — | $37K |
| MARQUEE HEALTH WELLNESS | Other services Service code 49 | 233 W. ERIE STREET 75W CHICAGO, IL 60654 | $6K |
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 | 251 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 251 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 215 | $149K |
| Vision | VISION SERVICE PLAN | 178 | $24K |
| Life insurance(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 327 | $189K |
| Short-term disability(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 327 | $189K |
| Long-term disability(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 327 | $189K |
| Stop-loss / reinsurancereinsurance | AETNA LIFE INSURANCE COMPANY | 251 | $464K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 327 | $168K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 327 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.