| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SERVICES, I | 263 SHUMAN BOULEVARD SUITE 110 NAPERVILLE, IL 60563 | BLUECROSS BLUESHIELD OF ILLINOIS | $87K | $2K | $89K | 4.20% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SVCS INC | 263 SHUMAN BOULEVARD SUITE 110 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 5.63% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SVCS INC | 263 SHUMAN BOULEVARD SUITE 110 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $5K | 10.95% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SVCS INC | 263 SHUMAN BOULEVARD SUITE 110 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $750 | $3K | 12.92% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SVCS INC | 263 SHUMAN BOULEVARD SUITE 110 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $695 | $4K | 16.08% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SVCS INC | 263 SHUMAN BOULEVARD SUITE 110 NAPERVILLE, IL 60563 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $654 | $3K | 19.16% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INSURANCE SERVICES, I | 1301 WEST 22ND STREET SUITE 600 OAK BROOK, IL 60523 | VISION SERVICE PLAN | $872 | — | $872 | 6.35% |
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 | 105 | 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) | 105 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 219 | $2.1M |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 68 | $70K |
| Vision | VISION SERVICE PLAN | 77 | $14K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 93 | $66K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 101 | $26K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 93 | $24K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 93 | $66K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 219 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.