| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2 PIERCE PLACE ITASCA, IL 60143 | BLUE CROSS BLUE SHIELD OF ILLINOIS (1) | $64K | $2K | $67K | 2.26% |
| THE STEWART AGENCY3 Filed as: THE STEWART GROUP INC. | 720 MASON LANE LAKE IN THE HILLS, IL 60156 | BLUE CROSS BLUE SHIELD OF ILLINOIS (1) | $64K | — | $64K | 2.19% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2 PIERCE PLACE ITASCA, IL 60143 | BLUE CROSS BLUE SHIELD OF ILLINOIS (2) | $6K | — | $6K | 2.68% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2 PIERCE PLACE ITASCA, IL 60143 | UNITED OF OMAHA LIFE INSURANCE COMPANY (5) | $9K | $1K | $10K | 17.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2 PIERCE PLACE ITASCA, IL 60143 | EYEMED VISION CARE | $5K | — | $5K | 9.94% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2 PIERCE PLACE ITASCA, IL 60143 | UNITED OF OMAHA LIFE INSURANCE COMPANY (4) | $6K | $834 | $6K | 17.22% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2 PIERCE PLACE ITASCA, IL 60143 | UNITED OF OMAHA LIFE INSURANCE COMPANY (6) | $4K | $540 | $4K | 17.18% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2 PIERCE PLACE ITASCA, IL 60143 | UNITED OF OMAHA LIFE INSURANCE COMPANY (3) | $2K | $356 | $2K | 12.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2 PIERCE PLACE ITASCA, IL 60143 | UNITED OF OMAHA LIFE INSURANCE COMPANY (2) | $2K | $219 | $2K | 16.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2 PIERCE PLACE ITASCA, IL 60143 | UNITED OF OMAHA LIFE INSURANCE COMPANY (1) | $2K | $260 | $2K | 17.40% |
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 | 0 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS (1) | 668 | $2.9M |
| Dental | BLUE CROSS BLUE SHIELD OF ILLINOIS (2) | 746 | $215K |
| Vision | EYEMED VISION CARE | 719 | $48K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY (6) | 419 | $40K |
| Short-term disability(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY (5) | 419 | $84K |
| Long-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY (4) | 172 | $48K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 746 | — |
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.