| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY, LTD | 1 CENTURY CENTER 1750 EAST GOLF ROAD OSAGE BEACH, IL 60173 | BLUECROSS BLUESHIELD OF ILLINOIS | $92K | $14 | $92K | 3.87% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: CONNOR & GALLAGHER BENEFITS SERVICE | 4933 LINCOLN AVENUE SUITE 5 LISLE, IL 60532 | BLUECROSS BLUESHIELD OF ILLINOIS | $2K | $3 | $2K | 0.09% |
| DYNAMIC MANUFACTURING, INC.3 Filed as: DYNAMIC MANUFACTURING, INC | 1930 NORTH MANNHEIM ROAD MELROSE PARK, IL 60160 | BLUECROSS BLUESHIELD OF ILLINOIS | — | $25 | $25 | 0.00% |
| ASSURANCE AGENCY LTD3 | 1750 EAST GOLF ROAD SUITE 1100 SCHAUMBURG, IL 60173 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $44K | $5K | $49K | 16.80% |
| ASSURANCE AGENCY LTD3 | 1750 EAST GOLF ROAD 11TH FLOOR SCHAUMBURG, IL 60173 | UNION SECURITY INSURANCE COMPANY | $14K | $316 | $14K | 10.62% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 EAST GOLF ROAD SCHAUMBURG, IL 60173 | NATIONAL VISION ADMINISTRATORS, L.L.C | $2K | — | $2K | 10.00% |
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 | 329 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 15 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 346 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 412 | $2.4M |
| Dental | UNION SECURITY INSURANCE COMPANY | 177 | $131K |
| Vision | NATIONAL VISION ADMINISTRATORS, L.L.C | 230 | $16K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 617 | $291K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 617 | $291K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 617 | $291K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 617 | $291K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 617 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.