| 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 | $18K | $296 | $18K | 2.68% |
| EUCLID MANAGERS3 | 234 SPRING LAKE DR ITASCA, IL 601433202 | UNITEDHEALTHCARE INSURANCE COMPANY | $6K | — | $6K | 0.91% |
| 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 Filed as: MARC JACOB JACOBSON | 425 HUEHL RD BLDG 16B NORTHBROOK, IL 600622366 | UNITEDHEALTHCARE INSURANCE COMPANY | $675 | — | $675 | 2.32% |
| EUCLID MANAGERS3 | 234 SPRING LAKE DR ITASCA, IL 601433202 | UNITEDHEALTHCARE INSURANCE COMPANY | $479 | — | $479 | 1.65% |
| MARC JACOBSON3 | 425 HUEHL RD BLDG 16B NORTHBROOK, IL 600622366 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | — | $1K | 9.40% |
| MARC JACOBSON3 | 425 HUEHL ROAD UNIT 16B NORTHBROOK, IL 60062 | ANTHEM BLUE CROSS | $102 | — | $102 | 12.16% |
| MARC JACOBSON3 Filed as: MARC JACOBSON & ASSOCIATES | 425 HUEHL ROAD UNIT 16B NORTHBROOK, IL 60062 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $82 | — | $82 | 15.05% |
| MARC JACOBSON3 Filed as: MARC JACOBSON & ASSOCIATES | 425 HUEHL ROAD UNIT 16B NORTHBROOK, IL 60062 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $68 | — | $68 | 14.98% |
| MARC JACOBSON3 Filed as: MARC JACOBSON & ASSOCIATES | 425 HUEHL RD UNIT 16B NORTHBROOK, IL 60062 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $57 | — | $57 | 15.12% |
| MARC JACOBSON3 Filed as: MARC JACOBSON & ASSOCIATES | 425 HUEHL ROAD UNIT 16B NORTHBROOK, IL 60062 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $32 | — | $32 | 10.13% |
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 | 108 | 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) | 108 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | UNITEDHEALTHCARE INSURANCE COMPANY | 117 | $713K |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF ILLINOIS | 47 | $53K |
| Vision | ANTHEM BLUE CROSS | 0 | $839 |
| Life insurance(3 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 108 | $15K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 23 | $377 |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 6 | $454 |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 108 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 117 | — |
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.