| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: CONNOR & GALLAGHER | 750 WARRENVILLE RD STE 400 LISLE, IL 60532 | BLUECROSS BLUESHIELD OF ILLINOIS | $67K | $2K | $70K | 4.16% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: CONNOR & GALLAGHER | 750 WARRENVILLE RD STE 400 LISLE, IL 60532 | DEARBORN LIFE INSURANCE COMPANY | $14K | — | $14K | 9.88% |
| WATCHTOWER BENEFITS, LLC3 Filed as: WATCHTOWER BENEFITS LLC | 2734 NORTH MILDRED AVENUE #3 CHICAGO, IL 60614 | DEARBORN LIFE INSURANCE COMPANY | — | $2K | $2K | 1.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BOON ADMINISTRATIVE SERVICES EIN 33-0449333 CONTRACTED THIRD PARTY | Claims processing; Other insurance fees and expenses; Contract Administrator; Direct payment from the plan Service code 12 | — | $138K |
| THE BOON INSURANCE EIN 74-2236168 MARKETING AGENT | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $724 |
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 | 170 | 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) | 170 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 231 | $1.7M |
| Dental | BLUECROSS BLUESHIELD OF ILLINOIS | 231 | $1.7M |
| Vision | DEARBORN LIFE INSURANCE COMPANY | 164 | $141K |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 164 | $141K |
| Short-term disability | DEARBORN LIFE INSURANCE COMPANY | 164 | $141K |
| Long-term disability | DEARBORN LIFE INSURANCE COMPANY | 164 | $141K |
| Other | DEARBORN LIFE INSURANCE COMPANY | 164 | $141K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 231 | — |
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.