| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 | 20 N MARTINGALE RD STE 100 SCHAUMBURG, IL 60173 | BLUECROSS BLUESHIELD OF ILLINOIS | $64K | $2K | $67K | 3.23% |
| ASSURANCE AGENCY LTD3 | 20 N. MARTINGALE RD., STE.100 SCHAUMBURG, IL 60173 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | $1K | $11K | 11.27% |
| ASSURANCE AGENCY LTD3 | ONE CENTURY CENTRE 20 N MARTINGALE RD STE 100 SCHAUMBURG, IL 60173 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | $858 | $8K | 11.15% |
| ASSURANCE AGENCY LTD3 | 20 N MARTINGALE RD STE 100 SCHAUMBURG, IL 60173 | VISION SERVICE PLAN | $1K | $123 | $2K | 10.00% |
| ASSURANCE AGENCY LTD3 | ONE CENTURY CENTRE 20 N MARTINGALE RD STE 100 SCHAUMBURG, IL 60173 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $906 | $112 | $1K | 11.23% |
| ASSURANCE AGENCY LTD3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $742 | $73 | $815 | 10.98% |
| ASSURANCE AGENCY LTD3 | 20 N MARTINGALE RD STE 100 SCHAUMBURG, IL 60173 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $858 | $858 | — |
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 | 243 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 247 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 298 | $2.1M |
| Dental | BLUECROSS BLUESHIELD OF ILLINOIS | 298 | $2.1M |
| Vision | VISION SERVICE PLAN | 146 | $15K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 210 | $75K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 14 | $7K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 124 | $95K |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 210 | $84K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 298 | — |
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.