| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E GOLF RD SCHAUMBURG, IL 60173 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $72K | $2K | $74K | 2.04% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY, LTD | 1750 E GOLF RD SCHAUMBURG, IL 60173 | METROPOLITAN LIFE INSURANCE CO | $41K | $5K | $46K | 21.28% |
| PAUL GLOBAL BENEFITS INC3 Filed as: PAUL BARTMAN | 1750 E GOLF RD SCHAUMBURG, IL 60173 | METROPOLITAN LIFE INSURANCE CO | $31K | — | $31K | 14.54% |
| ASSURANCE AGENCY LTD3 | 1750 EAST GOLF ROAD STE 1100 SCHAUMBURG, IL 60173 | PRINCIPAL LIFE INSURANCE COMPANY | $17K | — | $17K | 7.77% |
| ASSURANCE AGENCY LTD3 | 1750 E GOLF RD STE 140 CHICAGO, IL 60173 | VISION SERVICE PLAN | $1K | — | $1K | 5.35% |
| M BLOCK3 | 16619 S PINECREEK DR LOCKPORT, IL 60441 | COLONIAL LIFE AND ACCIDENT | $1K | $695 | $2K | 17.70% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E GOLF RD SCHAUMBURG, IA 60173 | COLONIAL LIFE AND ACCIDENT | $1K | $511 | $2K | 15.66% |
| D T WEINSTEIN3 Filed as: D WEINSTEIN | 601 W JACKSON BLVD, UNIT 912 CHICAGO, IL 60661 | COLONIAL LIFE AND ACCIDENT | $635 | $697 | $1K | 11.98% |
| K KENNEDY3 | 601 W JACKSON BLVD CHICAGO, IL 60661 | COLONIAL LIFE AND ACCIDENT | $224 | $266 | $490 | 4.41% |
| R STERNBERG3 | 374 MILFORD RD DEERFIELD, IL 60015 | COLONIAL LIFE AND ACCIDENT | $224 | $31 | $255 | 2.29% |
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 | 279 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 282 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 606 | $3.6M |
| Dental | METROPOLITAN LIFE INSURANCE CO | 976 | $215K |
| Vision | VISION SERVICE PLAN | 250 | $22K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 464 | $215K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 464 | $215K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 464 | $215K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT | 243 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 976 | — |
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.