| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | — | BLUECROSS BLUESHIELD OF ILLINOIS | $46K | $2K | $49K | 4.21% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY DBA ASSURAN | 20 N. MARTINGALE RD. STE 100 SCHAUMBURG, IL 60173 | PRINCIPAL LIFE INSURANCE COMPANY | $12K | — | $12K | 12.04% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | 1600 W. 7TH STREET FORT WORTH, TX 76102 | PRINCIPAL LIFE INSURANCE COMPANY | — | $188 | $188 | 0.19% |
| MARSH & MCLENNAN AGENCY LLC3 | 20 N. MARTINGALE RD STE 100 SCHAUMBURG, IL 60173 | METROPOLITAN LIFE INSURANCE COMPANY | $886 | $32 | $918 | 10.28% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $443 | $89 | $532 | 5.96% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN | 250 PEHLE AVE STE 400 SPARK 80 PLAZA 2 SADDLE BROOK, NJ 07663 | METROPOLITAN LIFE INSURANCE COMPANY | — | $111 | $111 | 1.24% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY, LLC | 6279 TRI RIDGE BLVD STE 400 LOVELAND, OH 45140 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3 | $3 | 0.03% |
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 | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 110 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 139 | $1.2M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 167 | $101K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 166 | $9K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 167 | $101K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 167 | $101K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 167 | $101K |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 167 | $101K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 167 | — |
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.