| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | UNKNOWN ADDISON, IL 60101 | BLUECROSS BLUESHIELD OF ILLINOIS | $91K | $2K | $94K | 2.76% |
| USI INSURANCE SERVICES LLC3 | 222 SOUTH RIVERSIDE PLAZA SUITE 900 CHICAGO, IL 60606 | BLUECROSS BLUESHIELD OF ILLINOIS | $47K | $0 | $47K | 1.40% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY, LTD. | UNKNOWN ADDISON, IL 60101 | BLUECROSS BLUESHIELD OF ILLINOIS | $0 | $6K | $6K | 0.18% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | 2300 RENAISSANCE BOULEVARD KING OF PRUSSIA, PA 19406 | DEARBORN LIFE INSURANCE COMPANY | $10K | $0 | $10K | 6.82% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY, LTD. | 20 MARTINGALE ROAD, SUITE 100 SCHAUMBURG, IL 60173 | DEARBORN LIFE INSURANCE COMPANY | $0 | $7K | $7K | 4.82% |
| USI INSURANCE SERVICES LLC3 | 222 SOUTH RIVERSIDE PLAZA SUITE 900 CHICAGO, IL 60606 | DEARBORN LIFE INSURANCE COMPANY | $5K | $0 | $5K | 3.17% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY, LTD. | 20 MARTINGALE ROAD, SUITE 100 SCHAUMBURG, IL 60173 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $2K | $0 | $2K | 7.26% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $584 | $0 | $584 | 2.57% |
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 | 261 | 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) | 261 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 518 | $3.4M |
| Dental | BLUECROSS BLUESHIELD OF ILLINOIS | 518 | $3.4M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 427 | $23K |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 298 | $145K |
| Short-term disability | DEARBORN LIFE INSURANCE COMPANY | 298 | $145K |
| Long-term disability | DEARBORN LIFE INSURANCE COMPANY | 298 | $145K |
| Prescription drug | BLUECROSS BLUESHIELD OF ILLINOIS | 518 | $3.4M |
| Other | DEARBORN LIFE INSURANCE COMPANY | 298 | $145K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 518 | — |
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.