| 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 | $58K | $2 | $58K | 3.48% |
| ATMI PRECAST3 | 960 RIDGEWAY AVENUE AURORA, IL 60506 | BLUE CROSS BLUE SHIELD OF ILLINOIS | — | $4 | $4 | 0.00% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E GOLF RD SUITE 1100 SCHAUMBURG, IL 60173 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 10.52% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 111 NORTH CANAL STREET #550 CHICAGO, IL 60606 | FIDELITY | $467 | — | $467 | 7.24% |
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 | 107 | 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) | 107 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 403 | $1.7M |
| Dental | BLUE CROSS BLUE SHIELD OF ILLINOIS | 403 | $1.7M |
| Vision | FIDELITY | 134 | $6K |
| Life insurance | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 264 | $42K |
| Short-term disability | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 264 | $42K |
| Long-term disability | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 264 | $42K |
| Other | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 264 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 403 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.