| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM AND BUTLER | 800 MAIN ST DUBUQUE, IA 52001 | BLUECROSS BLUESHIELD OF ILLINOIS | $58K | $5K | $63K | 4.12% |
| COYLE-KILEY INSURANCE AGENCY INC3 Filed as: COYLE-KILEY INSURANCE AGENCY, INC | 810 NORTH ALPINE RD ROCKFORD, IL 61107 | BLUECROSS BLUESHIELD OF ILLINOIS | $4K | — | $4K | 0.24% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF ILLINOIS, LLC | 4350 WEAVER PKWY WARRENVILLE, IL 60555 | VISION SERVICE PLAN | $801 | — | $801 | 6.75% |
| COYLE-KILEY INSURANCE AGENCY INC3 Filed as: COYLE-KILEY INSURANCE AGENCY, INC. | 810 N ALPINE RD ROCKFORD, IL 61107 | VISION SERVICE PLAN | $78 | — | $78 | 0.66% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM AND BUTLER INS SERVICES | 800 MAIN STREET DUBUQUE, IA 52001 | DEARBORN LIFE INSURANCE COMPANY | $1K | $585 | $2K | 17.73% |
| CHAD L NELSON3 | 2350 BETHANY RD SYCAMORE, IL 60178 | DEARBORN LIFE INSURANCE COMPANY | $69 | — | $69 | 0.70% |
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 | 133 | 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) | 133 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 143 | $1.5M |
| Dental | BLUECROSS BLUESHIELD OF ILLINOIS | 143 | $1.5M |
| Vision | VISION SERVICE PLAN | 88 | $12K |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 126 | $10K |
| Other | DEARBORN LIFE INSURANCE COMPANY | 126 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 143 | — |
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.