| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY LTD. | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | BLUECROSS BLUESHIELD OF ILLINOIS | $57K | $1K | $58K | 3.97% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY LTD. | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $449 | $8K | 15.87% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY LTD. | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $265 | $5K | 15.87% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY LTD. | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $273 | $4K | 16.06% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY LTD. | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | VISION SERVICE PLAN | $1K | — | $1K | 5.56% |
| JOHN A. CORP.3 Filed as: JOHN A CORP. | 1111 W, 22ND ST., STE. 620 OAK BROOK, IL 60523 | VISION SERVICE PLAN | $221 | — | $221 | 1.12% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY LTD. | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | DELTA DENTAL | $7K | — | $7K | 50.56% |
| JENNON M CARUTH3 | 7825 WASHINGTON AVE., STE. 710 BLOOMINGTON, MN 55439 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $433 | $6K | 41.84% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 25.74% |
| JENNON CARUTH3 | 7825 WASHINGTON AVE S, STE 710 BLOOMINGTON, MN 55439 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $156 | $3K | 48.88% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 30.69% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY LTD. | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $625 | $37 | $662 | 15.88% |
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 | 175 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 35 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 210 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 244 | $1.5M |
| Dental | DELTA DENTAL | 125 | $15K |
| Vision | VISION SERVICE PLAN | 115 | $20K |
| Life insurance(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 141 | $10K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 174 | $51K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 174 | $31K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 141 | $43K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 244 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.