| 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 IL | $31K | $3K | $33K | 4.44% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY, LTD | 1750 EAST GOLF ROAD, STE 1100 SCHAUMBURG, IL 60173 | AMERITAS LIFE INSURANCE CORP | $2K | $622 | $3K | 6.56% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E GOLF RD, STE 140 SCHAUMBURG, IL 60173 | VISION SERVICE PLAN | $592 | — | $592 | 8.65% |
| FLEXIBLE BENEFIT SERVICE CORP3 | 8700 W BRYN MAWR AVE., STE 1010S CHICAGO, IL 60631 | VISION SERVICE PLAN | $342 | — | $342 | 5.00% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY, LTD | 1750 E GOLF ROAD, STE 1100 SCHAUMBURG, IL 60173 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $630 | $282 | $912 | 21.42% |
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 | 112 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF IL | 169 | $753K |
| Dental | AMERITAS LIFE INSURANCE CORP | 187 | $47K |
| Vision | VISION SERVICE PLAN | 77 | $7K |
| Life insurance | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 184 | $4K |
| Other | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 184 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 187 | — |
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.