| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE PLEXUS GROUPE LLC3 | 21805 FIELD PKWY #300 DEER PARK, IL 60010 | BLUECROSS BLUESHIELD OF ILLINOIS | — | $19K | $19K | 0.09% |
| THE PLEXUS GROUPE LLC3 Filed as: THE PLEXUS GROUP LLC | 21805 W FIELD PKWY UNIT 300 DEER PARK, IL 600103231 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $22K | $22K | 1.63% |
| THE PLEXUS GROUPE LLC3 | 21805 FIELD PARKWAY, SUITE 300 DEER PARK, IL 60010 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $74K | $37K | $110K | 8.54% |
| THE PLEXUS GROUPE LLC3 | 21805 FIELD PKWY, STE 300 DEER PARK, IL 60010 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $7K | — | $7K | 10.77% |
| CUSTOM BENEFIT PROGRAMS INC3 | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $419 | $2K | 2.73% |
| J M PRUDHOMME3 | 3071 HONEY TREE DR GERMANTOWN, TN 38138 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $480 | — | $480 | 0.77% |
| WALTER R FAWCETT III3 | 21805 FIELD PKWY, STE 300 DEER PARK, IL 60010 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $204 | — | $204 | 0.33% |
| LOUIS R FAIOLA3 Filed as: LOUIS J PANTALONE | PO BOX 1116 HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $138 | — | $138 | 0.22% |
| JOHN R JOHN3 | 948 REDDOCH CV MEMPHIS, TN 38119 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $67 | — | $67 | 0.11% |
| THE PLEXUS GROUPE LLC3 | 21805 FIELD PKWY STE 300 DEER PARK, IL 60010 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $378 | $7 | $385 | 1.23% |
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 | 2,358 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 19 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,390 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 4,026 | $21.3M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 4,011 | $1.4M |
| Vision | VISION SERVICE PLAN | 722 | $122K |
| Life insurance(2 contracts, 2 carriers) | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 2,419 | $1.4M |
| Long-term disability | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 2,419 | $1.3M |
| Other(3 contracts, 3 carriers) | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 2,419 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,026 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
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.