| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KAMM INSURANCE GROUP3 | 7N024 MEDINAH RD PO BOX 129 MEDINAH, IL 60157 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $108K | $5K | $112K | 2.03% |
| MYERS-BRIGGS & CO3 | 300 S WACKER DR STE 1000 CHICAGO, IL 60606 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $14K | — | $14K | 2.88% |
| MYERS-BRIGGS & CO3 | 300 WACKER DRIVE STE 1000 CHICAGO, IL 60606 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $22K | — | $22K | 14.04% |
| WORKPLACE SOLUTIONS, INC.3 | 120-A GILLIS CREEK PKWY COLUMBIA, SC 29209 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $19K | $2K | $21K | 15.21% |
| BENEFIT COMMUNICATIONS INC3 | 2977 SIDCO DR NASHVILLE, TN 37204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $18K | $3K | $21K | 14.93% |
| KAMM INSURANCE GROUP3 Filed as: KAMM INSURANCE GROUP INC. | 300 S WACKER DR STE 100 CHICAGO, IL 60606 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15K | — | $15K | 11.02% |
| BOUDREAUX, BEAU, DAVID3 Filed as: BOUDREAUX BEAU DAVID | 120-A GILLIS CRK PKWY COLUMBIA, SC 29209 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 1.73% |
| MORRIS, CHRISTOPHER, ROBERT3 Filed as: MORRIS CHRISTOPHER ROBERT | 2977 SIDCO DR NASHVILLE, TN 37204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $82 | $1K | 0.78% |
| KAMM INSURANCE GROUP3 | 300 S WACKER DR STE 1000 CHICAGO, IL 60606 | EYEMED VISION CARE | $534 | — | $534 | 0.93% |
| KAMM INSURANCE GROUP3 | PO BOX 129 MEDINAH, IL 60157 | EYEMED VISION CARE | $5K | — | $5K | 6904.41% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF ILLINOIS EIN 36-1236610 ADMINISTRATOR | Contract Administrator Service code 13 | 300 EAST RANDOLPH STREET CHICAGO, IL 60601 | $521K |
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 | 1,391 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,391 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 1,397 | $5.5M |
| Dental | DELTA DENTAL | 643 | $29K |
| Vision(2 contracts) | EYEMED VISION CARE | 1,486 | $57K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 404 | $155K |
| Short-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 728 | $628K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 728 | $489K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 442 | $139K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,486 | — |
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.