| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY, LTD | 1750 EAST GOLF ROAD SUITE 140 CHICAGO, IL 60173 | BLUECROSS BLUESHIELD OF ILLINOIS | $57K | — | $57K | 3.85% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTENATIONAL MIDWEST | 55 EAST JACKSON BOULEVARD CHICAGO, IL 60604 | BLUECROSS BLUESHIELD OF ILLINOIS | — | $3K | $3K | 0.19% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 EAST GOLF ROAD SCHAUMBURG, IL 60173 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $3K | $7K | 6.54% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 EAST GOLF ROAD SCHAUMBURG, IL 60173 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $407 | $4K | 16.64% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E GOLF ROAD SCHAUMBURG, IL 60173 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $178 | $2K | 18.87% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY, LTD | 1750 EAST GOLF ROAD SUITE 1100 SCHAUMBURG, IL 60173 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $337 | $302 | $639 | 10.54% |
| ASSURANCE AGENCY LTD3 | 1750 EAST GOLF ROAD SUITE 1100 SCHAUMBURG, IL 60173 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $838 | — | $838 | 15.00% |
| FMLA SOURCE INC3 | 455 NORTH CITYFRONT PLAZA DRIVE 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $677 | $677 | 12.12% |
| ASSURANCE AGENCY LTD3 | 1750 EAST GOLF ROAD SUITE 1100 SCHAUMBURG, IL 60173 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $760 | — | $760 | 14.99% |
| ASSURANCE AGENCY LTD3 | 1750 EAST GOLF ROAD SUITE 1100 SCHAUMBURG, IL 60173 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $154 | — | $154 | 10.01% |
| UNITED OF OMAHA LIFE INSURANCE CO3 | MUTUAL OF OMAHA PLAZA OMAHA, NE 68175 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | — |
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 | 131 | 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) | 131 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 256 | $1.5M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 399 | $105K |
| Vision | VISION SERVICE PLAN | 122 | $13K |
| Life insurance(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 131 | $22K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 131 | $0 |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 131 | $27K |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 131 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 399 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.