| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VISTA NATIONAL INSURANCE GROUP INC3 | — | BLUECROSS BLUESHIELD OF ILLINOIS | $68K | $2K | $70K | 4.04% |
| VISTA NATIONAL INSURANCE GROUP INC3 | 1301 WEST 22ND STREET SUITE 600 OAK BROOK, IL 60523 | BLUECROSS BLUESHIELD OF ILLINOIS | — | $1 | $1 | 0.00% |
| VISTA NATIONAL INSURANCE GROUP INC3 | 1415 WEST 22ND STREET SUITE 1000 OAK BROOK, IL 60523 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 3.99% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF ILLINOIS INC | 300 NORTH BEACH STREET DAYTONA BEACH, FL 32114 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $100 | — | $100 | 0.14% |
| VISTA NATIONAL INSURANCE GROUP INC3 | 1415 WEST 22ND STREET SUITE 1000 OAK BROOK, IL 60523 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $5K | 11.10% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF ILLINOIS INC | 300 NORTH BEACH STREET DAYTONA BEACH, FL 32114 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $191 | — | $191 | 0.42% |
| VISTA NATIONAL INSURANCE GROUP INC3 | 1415 WEST 22ND STREET SUITE 1000 OAK BROOK, IL 60523 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $712 | $3K | 12.31% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF ILLINOIS INC | 300 NORTH BEACH STREET DAYTONA BEACH, FL 32114 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $192 | — | $192 | 0.85% |
| VISTA NATIONAL INSURANCE GROUP INC6 | 1415 WEST 22ND STREET SUITE 1000 OAK BROOK, IL 60523 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $689 | $3K | 15.85% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF ILLINOIS INC | 300 NORTH BEACH STREET DAYTONA BEACH, FL 32114 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $181 | — | $181 | 0.84% |
| VISTA NATIONAL INSURANCE GROUP INC3 | 1415 WEST 22ND STREET SUITE 1000 OAK BROOK, IL 60523 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $568 | $3K | 16.66% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF ILLINOIS INC | 300 NORTH BEACH STREET DAYTONA BEACH, FL 32114 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $255 | — | $255 | 1.35% |
| VISTANATIONAL INSURANCE GROUP3 | 1301 WEST 22ND STREET SUITE 600 OAK BROOK, IL 60523 | VISION SERVICE PLAN | $619 | — | $619 | 4.67% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF ILLINOIS, INC | 1301 WEST 22ND STREET SUITE 600 OAK BROOK, IL 60523 | VISION SERVICE PLAN | $334 | — | $334 | 2.52% |
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 | 107 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 108 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 228 | $1.7M |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 88 | $70K |
| Vision | VISION SERVICE PLAN | 75 | $13K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 107 | $64K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 107 | $23K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 107 | $22K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 107 | $64K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 228 | — |
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.