| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1111 WEST 22ND STREET OAKBROOK, IL 60523 | BLUECROSS BLUESHIELD OF ILLINOIS | $33K | $2K | $35K | 3.58% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY INC | 225 KENNETH DRIVE ROCHESTER, NY 14623 | BLUECROSS BLUESHIELD OF ILLINOIS | $6K | $0 | $6K | 0.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | PRINCIPAL LIFE INSURANCE COMPANY | $10K | $0 | $10K | 6.39% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY INC | 225 KENNETH DRIVE ROCHESTER, NY 14623 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 1.64% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1111 WEST 22ND STREET OAKBROOK, IL 60523 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $794 | $0 | $794 | 8.51% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY | PO BOX 948 HENRIETTA, NY 14467 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $66 | $0 | $66 | 0.71% |
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 | 109 | 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) | 109 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 104 | $988K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 137 | $153K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 122 | $9K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 137 | $153K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 137 | $153K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 137 | $153K |
| Prescription drug | BLUECROSS BLUESHIELD OF ILLINOIS | 104 | $988K |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 137 | $153K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 137 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.