| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARC JACOBSON3 Filed as: MARC JACOB JACOBSON | 425 HUEHL RD BLDG 16B NORTHBROOK, IL 600622366 | UNITEDHEALTHCARE INSURANCE COMPANY | $19K | $163 | $19K | 2.95% |
| EUCLID MANAGERS3 | 234 SPRING LAKE DR ITASCA, IL 601433202 | UNITEDHEALTHCARE INSURANCE COMPANY | $8K | — | $8K | 1.17% |
| MARC JACOBSON3 Filed as: MARC JACOB JACOBSON | 425 HUEHL RD BLDG 16B NORTHBROOK, IL 600622366 | UNITEDHEALTHCARE INSURANCE COMPANY | $4K | $80 | $4K | 2.32% |
| EUCLID MANAGERS3 | 234 SPRING LAKE DR ITASCA, IL 601433202 | UNITEDHEALTHCARE INSURANCE COMPANY | $2K | — | $2K | 1.13% |
| MARC JACOBSON3 Filed as: MARC JACOBSON & ASSOCIATES | 425 HUEHL ROAD SUITE 16B NORTHBROOK, IL 600620000 | DELTA DENTAL OF ILLINOIS | $4K | — | $4K | 7.50% |
| MARC JACOBSON3 | 425 HUEHL RD BLDG 16B NORTHBROOK, IL 600622366 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $67 | $2K | 10.93% |
| MARC JACOBSON3 | 5 REVERE DRIVE #400 NORTHBROOK, IL 60062 | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | $592 | — | $592 | 9.86% |
| MARC JACOBSON3 Filed as: MARC JACOBSON & ASSOCIATES | 425 HUEHL ROAD UNIT 16B NORTHBROOK, IL 60062 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $514 | — | $514 | 14.99% |
| MARC JACOBSON3 Filed as: MARC JACOBSON & ASSOCIATES | 425 HUEHL ROAD UNIT 16B NORTHBROOK, IL 60062 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $412 | — | $412 | 15.00% |
| MARC JACOBSON3 Filed as: MARC JACOBSON & ASSOCIATES | 425 HUEHL RD UNIT 16B NORTHBROOK, IL 60062 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $352 | — | $352 | 15.01% |
| MARC JACOBSON3 Filed as: MARC JACOBSON & ASSOCIATES | 425 HUEHL ROAD UNIT 16B NORTHBROOK, IL 60062 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $147 | — | $147 | 10.01% |
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 | 151 | 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) | 151 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | UNITEDHEALTHCARE INSURANCE COMPANY | 119 | $814K |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF ILLINOIS | 46 | $57K |
| Vision | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 20 | $6K |
| Life insurance(3 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 116 | $19K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 25 | $2K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 6 | $3K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 116 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 119 | — |
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."
No prospect flags tripped on this filing.