| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENICO LTD3 Filed as: BENICO, LTD. | 11715 MAIN ST. P O BOX 8 HUNTLEY, IL 60142 | BLUECROSS BLUESHIELD OF ILLINOIS | $43K | $705 | $43K | 4.00% |
| BENICO LTD3 Filed as: BENICO, LTD | 11715 MAIN ST. P O BOX 8 HUNTLEY, IL 60142 | THE GUARDIAN LIFE INSURANCE COMPANY | $12K | — | $12K | 9.39% |
| NATIONAL BENEFIT CENTER3 Filed as: NATIONAL BENEFIT CENTER, LLC | 1105 N. MARKET ST. STE. 1300 WILMINGTON, DE 19801 | THE GUARDIAN LIFE INSURANCE COMPANY | $176 | — | $176 | 0.14% |
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 | 108 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 108 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 200 | $1.1M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY | 142 | $124K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY | 142 | $124K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY | 142 | $124K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY | 142 | $124K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY | 142 | $124K |
| Prescription drug | BLUECROSS BLUESHIELD OF ILLINOIS | 200 | $1.1M |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY | 142 | $124K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 200 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.