| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES, INC. | 353 NORTH CLARK STREET, SUITE 1100 CHICAGO, IL 60654 | UNITEDHEALTHCARE INSURANCE COMPANY | $4K | $7K | $11K | 9.58% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES, INC. | 353 NORTH CLARK STREET CHICAGO, IL 60654 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $10K | $3K | $13K | 18.26% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SOUTHWEST, INC. | 9811 KATY FREEWAY, SUITE 500 HOUSTON, TX 77024 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $0 | $4K | 5.95% |
| JEFFREY LYNN LAMBERT3 Filed as: JEFFREY L. LAMBERT AND OTHER AGENTS | 7 CENTER STREET HINSDALE, IL 60521 | CONTINENTAL AMERICAN INSURANCE COMPANY | $67 | $0 | $67 | 0.24% |
| KEN S KRAVITZ3 Filed as: KEN S. KRAVITZ | PO BOX 1284 BRIDGEVIEW, IL 60455 | CONTINENTAL AMERICAN INSURANCE COMPANY | $65 | $0 | $65 | 0.23% |
| NOLAN D MCCUE3 Filed as: NOLAN D. MCCUE | 242 HERITAGE PARK DRIVE, SUITE 108 MURFREESBORO, TN 37129 | CONTINENTAL AMERICAN INSURANCE COMPANY | $60 | $0 | $60 | 0.21% |
| ZUREK & ASSOCIATES LLC3 Filed as: LC ZUREK & ASSOCIATES, LLC | 210 DES PLAINES AVENUE, UNIT D FOREST PARK, IL 60130 | CONTINENTAL AMERICAN INSURANCE COMPANY | $46 | $0 | $46 | 0.16% |
| SHERRI L BASHORE3 Filed as: SHERRI L. BASHORE | PO BOX 40327 NASHVILLE, TN 37204 | CONTINENTAL AMERICAN INSURANCE COMPANY | $45 | $0 | $45 | 0.16% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES, INC. | 353 NORTH CLARK STREET CHICAGO, IL 60654 | CONTINENTAL AMERICAN INSURANCE COMPANY | $32 | $0 | $32 | 0.11% |
| KELSEY DAVID EVERT3 Filed as: KELSEY D. EVERT | 2055 NORTH MOUNT JULIET ROAD SUITE 201 MOUNT JULIET, TN 37122 | CONTINENTAL AMERICAN INSURANCE COMPANY | $30 | $0 | $30 | 0.11% |
| ETHAN GREER3 | 3253 EAST MALLORY BOULEVARD JUPITER, FL 33458 | AFLAC | $873 | $0 | $873 | 3.26% |
| THW INSURANCE SERVICES LLC3 Filed as: THW INSURANCE SERVICES, LLC | 321 WEST MAIN STREET LEBANON, TN 37087 | AFLAC | $527 | $0 | $527 | 1.97% |
| KIRK HASKINS3 Filed as: KIRK HASKINS AND OTHER AGENTS | 1043 NORTH NARCISSUS AVENUE BROKEN ARROW, OK 74012 | AFLAC | $433 | $0 | $433 | 1.62% |
| KELSEY DAVID EVERT3 | 2055 NORTH MOUNT JULIET ROAD SUITE 201 MOUNT JULIET, TN 37122 | AFLAC | $289 | $0 | $289 | 1.08% |
| TIMOTHY CHAPPELL3 | 522 ROCK SPRINGS ROAD WATERTOWN, TN 37184 | AFLAC | $214 | $0 | $214 | 0.80% |
| KEN S KRAVITZ3 Filed as: KEN S. KRAVITZ | 8841 SOUTH 84TH COURT HICKORY HILLS, IL 60457 | AFLAC | $118 | $0 | $118 | 0.44% |
| TODD DEVOSS3 Filed as: TODD C. DEVOSS | 321 NORTH CLARK STREET, SUITE 625 CHICAGO, IL 60654 | AFLAC | $106 | $0 | $106 | 0.40% |
| BROWNIE D HALL3 Filed as: BROWNIE D. HALL | 321 WEST MAIN STREET LEBANON, TN 37087 | AFLAC | $207 | $0 | $207 | 2.46% |
| JAMES C FARMER JR3 Filed as: JAMES C. FARMER, JR. | 261 CRIMSON SKY COURT DRIPPING SPRINGS, TX 78620 | AFLAC | $176 | $0 | $176 | 2.09% |
| KELSEY DAVID EVERT3 Filed as: KELSEY DAVID EVERT AND OTHER AGENTS | 2055 NORTH MOUNT JULIET ROAD SUITE 201 MOUNT JULIET, TN 37122 | AFLAC | $143 | $0 | $143 | 1.70% |
| RICK R THORNE3 Filed as: RICK R. THORNE | 321 WEST MAIN STREET LEBANON, TN 37087 | AFLAC | $116 | $0 | $116 | 1.38% |
| GARY W LOVELL3 Filed as: GARY W. LOVELL | PO BOX 90866 NASHVILLE, TN 37209 | AFLAC | $94 | $0 | $94 | 1.12% |
| RONALD H RICHEY3 Filed as: RONALD H. RICHEY | 4499 MURFREESBORO ROAD FRANKLIN, TN 37067 | AFLAC | $29 | $0 | $29 | 0.34% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES, INC. | 353 NORTH CLARK STREET CHICAGO, IL 60654 | AFLAC | $25 | $0 | $25 | 0.30% |
| KEN S KRAVITZ3 Filed as: KEN S. KRAVITZ | 8841 SOUTH 84TH COURT HICKORY HILLS, IL 60457 | AFLAC | $46 | $0 | $46 | 4.20% |
| H J SAMAAN INC3 Filed as: H J SAMAAN, INC. | 477 EAST BUTTERFIELD ROAD SUITE 206 LOMBARD, IL 60148 | AFLAC | $13 | $0 | $13 | 1.19% |
| LA FREY AND ASSOCIATES INC3 Filed as: LA FREY AND ASSOCIATES, INC. | 14466 SOUTH ELIZABETH LANE HOMER GLEN, IL 60491 | AFLAC | $11 | $0 | $11 | 1.00% |
| ELIZABETH M GASPAROVIC3 Filed as: ELIZABETH M. GASPAROVIC | 18 NORTH SMITH STREET PALATINE, IL 60067 | AFLAC | $4 | $0 | $4 | 0.36% |
| TOMMY L JOHNSON JR3 Filed as: TOMMY L. JOHNSON, JR. | 711 SOUTH OLIVE STREET APARTMENT 314 LOS ANGELES, CA 90014 | AFLAC | $4 | $0 | $4 | 0.36% |
| KEMP G PILE3 Filed as: KEMP G. PILE | 1525 TIMBERWOOD COURT SYCAMORE, IL 60178 | AFLAC | $1 | $0 | $1 | 0.09% |
| DANIEL J TAYLOR3 Filed as: DANIEL J. TAYLOR AND OTHER AGENTS | 2170 NORTH LAKE DRIVE APARTMENT 6032 COLUMBIA, SC 29212 | AFLAC | $1 | $0 | $1 | 0.09% |
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 | 115 | 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) | 115 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 230 | $113K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 230 | $113K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 114 | $69K |
| Short-term disability(4 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 19 | $65K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 114 | $69K |
| Other(5 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 114 | $134K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 230 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.