| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVID DANZIG & ASSOCIATES3 | 570 LAKE COOK ROAD SUITE 210 DEERFIELD, IL 60015 | HUMANA INSURANCE COMPANY | $24K | $489 | $24K | 3.41% |
| DAVID DANZIG & ASSOCIATES3 | 570 LAKE COOK ROAD SUITE 210 DEERFIELD, IL 60015 | HUMANADENTAL INSURANCE | $3K | $956 | $4K | 7.59% |
| ORLANDO R DOBRINCU3 | 15419 WEST 127TH STREET LEMONT, IL 60439 | AFLAC | $2K | $43 | $2K | 10.38% |
| NORMA HUERTA3 | 14420 SOUTH ALBANY AVENUE POSEN, IL 60469 | AFLAC | $340 | — | $340 | 1.91% |
| JEFF LAMBERT3 | 15419 WEST 127TH STREET LEMONT, IL 60439 | AFLAC | $305 | $16 | $321 | 1.80% |
| EDGAR E PUNTI3 | 5004 NORTH SPRINGFIELD AVENUE FLOOR 2 CHICAGO, IL 60625 | AFLAC | $220 | $34 | $254 | 1.42% |
| KIMBERLEY A DOBRINCU3 | 837 LINDEN CIRCLE HOFFMAN ESTATES, IL 60169 | AFLAC | $187 | — | $187 | 1.05% |
| MICHAEL I STONESIFER3 | 12504 CARDINAL CREEK DRIVE FRISCO, TX 75033 | AFLAC | $152 | — | $152 | 0.85% |
| THERESA NETTO PHILLIPS3 Filed as: THERESA V REDDING | 71 COUNTRY CLUB DRIVE BLOOMINGDALE, IL 60108 | AFLAC | $118 | $16 | $134 | 0.75% |
| ROGERS BENEFIT GROUP INC3 Filed as: JOHN P ROGERS | 824 PORTLAND DRIVE SCHAUMBURG, IL 60194 | AFLAC | $110 | — | $110 | 0.62% |
| JOSHUA J PARISE3 | 7325 JANES AVENUE WOODRIDGE, IL 60517 | AFLAC | $89 | — | $89 | 0.50% |
| TIMOTHY B ASBY3 | 9247 NORTH MERIDIAN STREET SUITE 205 INDIANAPOLIS, IN 46260 | AFLAC | $33 | $15 | $48 | 0.27% |
| JODY D WINTERS3 | 6014 GIESEKE DRIVE CRYSTAL LAKE, IL 60014 | AFLAC | $40 | — | $40 | 0.22% |
| CHAD L NELSON3 Filed as: CHAD NELSON | 490 EAST ROOSEVELT ROAD SUITE 203 WEST CHICAGO, IL 60185 | AFLAC | $32 | — | $32 | 0.18% |
| GARY A SPANRAFT3 | 58 GREENHEDGE CIRCLE DELAWARE, OH 43015 | AFLAC | $27 | — | $27 | 0.15% |
| JAMES CAPPEL3 | 24346 SOUTH DUPAGE DRIVE CHANNAHON, IL 60410 | AFLAC | $18 | — | $18 | 0.10% |
| MICHAEL SALVAGGIO3 | 1510 GLEN LAKE ROAD HOFFMAN ESTATES, IL 60169 | AFLAC | $18 | — | $18 | 0.10% |
| STEVE HATHORN3 | 4N960 MIDDLECREEK LANE SAINT CHARLES, IL 60175 | AFLAC | $11 | — | $11 | 0.06% |
| RICHARD N KOZLOWSKI3 | 39W195 CLIFF DRIVE ELGIN, IL 60124 | AFLAC | $10 | — | $10 | 0.06% |
| ELIZABETH M GASPAROVIC3 | 1531 WEST RUE JAMES PLACE PALATINE, IL 60067 | AFLAC | $8 | — | $8 | 0.04% |
| MICHAEL A ORTIZ3 | 3433 VOLTAIRE LANE SAINT CHARLES, IL 60175 | AFLAC | $6 | — | $6 | 0.03% |
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 | 143 | 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) | 143 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HUMANA INSURANCE COMPANY | 143 | $717K |
| Dental(2 contracts, 2 carriers) | HUMANADENTAL INSURANCE | 99 | $73K |
| Vision | HUMANADENTAL INSURANCE | 99 | $56K |
| Life insurance | HUMANA INSURANCE COMPANY | 143 | $717K |
| Other(2 contracts, 2 carriers) | HUMANA INSURANCE COMPANY | 143 | $735K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 143 | — |
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.