| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MESIROW INSURANCE SERVICES INC3 | 353 NORTH CLARK STREET STE 1100 CHICAGO, IL 60654 | UNITEDHEALTHCARE INSURANCE COMPANY | $4K | $28K | $32K | 3.24% |
| MESIROW INSURANCE SERVICES INC3 | 353 NORTH CLARK STREET CHICAGO, IL 60654 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $384 | $3K | 11.69% |
| MESIROW INSURANCE SERVICES INC3 | 353 NORTH CLARK STREET CHICAGO, IL 60654 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $342 | $2K | 11.96% |
| MESIROW INSURANCE SERVICES INC3 | 353 NORTH CLARK STREET CHICAGO, IL 60654 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $326 | $3K | 16.38% |
| MESIROW INSURANCE SERVICES INC3 | 353 N CLARK ST STE 1100 CHICAGO, IL 60654 | VISION SERVICE PLAN | $877 | — | $877 | 6.81% |
| MESIROW INSURANCE SERVICES INC3 | 353 NORTH CLARK STREET CHICAGO, IL 60654 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $980 | $123 | $1K | 16.87% |
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 | 130 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 130 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 225 | $986K |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 225 | $986K |
| Vision | VISION SERVICE PLAN | 91 | $13K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 130 | $29K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 45 | $17K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 129 | $17K |
| Other(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 130 | $29K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 225 | — |
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.