| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARC JACOBSON3 Filed as: MARC JACOBSON & ASSOCIATES | 425 HUEHL ROAD, SUITE 16B NORTHBROOK, IL 60062 | BLUE CROSS BLUE SHIELD OF ILLINOIS | — | $3K | $3K | 0.89% |
| MARC JACOBSON3 Filed as: MARC JACOBSON & ASSOCIATES | 425 HUEHL ROAD, SUITE 16B NORTHBROOK, IL 60062 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | — | $8K | 7.19% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3K | $3K | 2.19% |
| MARC JACOBSON3 Filed as: MARC JACOBSON & ASSOCIATES | 425 HUEHL ROAD, SUITE 16B NORTHBROOK, IL 60062 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 7.27% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 4.55% |
| MARC JACOBSON3 Filed as: MARC JACOBSON & ASSOCIATES | 425 HUEHL ROAD NORTHBROOK, IL 60062 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 7.19% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 4.36% |
| MARC JACOBSON3 Filed as: MARC JACOBSON & ASSOCIATES | 425 HUEHL ROAD NORTHBROOK, IL 60062 | GUARDIAN LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| MARK J MATSOCK & ASSOCIATES INC3 Filed as: MARK S METTILE | 107 CANDLELIGHT LANE MORRIS, IL 60450 | GUARDIAN LIFE INSURANCE COMPANY | $1K | — | $1K | 8.00% |
| MARC JACOBSON3 Filed as: MARC JACOBSON & ASSOCIATES | 425 HUEHL ROAD, SUITE 16B NORTHBROOK, IL 60062 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | — | $1K | 6.88% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | — | $783 | $783 | 4.30% |
| MARC JACOBSON3 Filed as: MARC JACOBSON & ASSOCIATES | 425 HUEHL ROAD, SUITE 16B NORTHBROOK, IL 60062 | METROPOLITAN LIFE INSURANCE COMPANY | $619 | — | $619 | 6.71% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | — | $387 | $387 | 4.20% |
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 | 799 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 799 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 799 | $342K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 673 | $134K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 673 | $18K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 673 | $54K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 673 | $40K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 673 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 799 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.