| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE BOON INSURANCE AGENCY3 Filed as: THE BOON INSURANCE AGENCY INC | 234 SPRING LAKE DR ITASCA, IL 60143 | UNITEDHEALTHCARE INSURANCE COMPANY | $4K | — | $4K | 7.00% |
| CLEAR INSIGHT BENEFITS CONSULTING3 | 451 DUNHAM ROAD, STE 600 SAINT CHARLES, IL 60174 | UNITEDHEALTHCARE INSURANCE COMPANY | $3K | — | $3K | 5.67% |
| CLEAR INSIGHT BENEFITS CONSULTING3 Filed as: CLEAR INSIGHT BENEFIT CONSULTING | PO BOX 97 WAYNE, IL 60184 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 13.71% |
| CLEAR INSIGHT BENEFITS CONSULTING3 Filed as: CLEAR INSIGHT BENEFIT CONSULTING | PO BOX 97 WAYNE, IL 60184 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 9.10% |
| CLEAR INSIGHT BENEFITS CONSULTING3 Filed as: CLEAR INSIGHT BENEFIT CONSULTING | PO BOX 97 WAYNE, IL 60184 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 13.44% |
| CLEAR INSIGHT BENEFITS CONSULTING3 Filed as: CLEAR INSIGHT BENEFIT CONSULTING | PO BOX 97 WAYNE, IL 60184 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| CLEAR INSIGHT BENEFITS CONSULTING3 | 451 DUNHAM ROAD 600 ST. CHARLES, IL 60174 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $536 | — | $536 | 4.63% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSING | Insurance services; Claims processing; Insurance brokerage commissions and fees Service code 12 | — | $45K |
| JAMES L LORENZ INS AGENTS AND BROKERS | Insurance agents and brokers Service code 22 | PO BOX 97 WAYNE, IL 60184 | $26K |
| THE BOON INSURANCE AGENCY INC INS AGENTS AND BROKERS | Insurance agents and brokers Service code 22 | 234 SPRING LAKE DR ITASCA, IL 60143 | $152 |
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 |
|---|---|---|---|
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 151 | $59K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 136 | $12K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 102 | $59K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 102 | $37K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 56 | $22K |
| Stop-loss / reinsurancereinsurance | ALL SAVERS INSURANCE COMPANY | 67 | $726K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 102 | $59K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 151 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.