| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E GOLF RD SCHAUMBURG, IL 60173 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $56K | — | $56K | 1.32% |
| AXION RMS LTD3 | 2165 WARRENVILLE RD DOWNERS GROVE, IL 60515 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $39K | — | $39K | 0.93% |
| MID AMERICAN GROUP, INC.3 Filed as: MID AMERICAN GROUP INC | 760 PASQUINELLI DR WESTMONT, IL 60559 | BLUE CROSS BLUE SHIELD OF ILLINOIS | — | $3K | $3K | 0.07% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E GOLF RD SCHAUMBURG, IL 60173 | UNUM LIFE INS CO OF AMERICA | $27K | $4K | $31K | 18.50% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E GOLF RD SCHAUMBURG, IL 60173 | SUN LIFE ASSURANCE CO | $20K | — | $20K | 13.60% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E GOLF RD SCHAUMBURG, IL 60173 | UNUM LIFE INS CO OF AMERICA | $17K | — | $17K | 19.89% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E GOLF RD SCHAUMBURG, IL 60173 | DELTA DENTAL OF ILLINOIS | $22K | — | $22K | 60.88% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E GOLF RD SCHAUMBURG, IL 60173 | SUN LIFE ASSURANCE CO | $4K | — | $4K | 18.32% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E GOLF RD SCHAUMBURG, IL 60173 | VSP | $2K | — | $2K | 10.00% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E GOLF RD SCHAUMBURG, IL 60173 | UNUM LIFE INSURANCE CO OF AMERICA | $3K | $319 | $3K | 22.50% |
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 | 394 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 408 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 622 | $4.2M |
| Dental | DELTA DENTAL OF ILLINOIS | 335 | $37K |
| Vision | VSP | 251 | $22K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INS CO OF AMERICA | 369 | $315K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INS CO OF AMERICA | 369 | $315K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INS CO OF AMERICA | 369 | $315K |
| Other(5 contracts, 3 carriers) | UNUM LIFE INS CO OF AMERICA | 369 | $434K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 622 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.