| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MESIROW INSURANCE SERVICES INC3 | 353 NORTH CLARK STREET SUITE 1100 CHICAGO, IL 60654 | BLUECROSS BLUESHIELD OF ILLINOIS | $77K | $2K | $79K | 3.02% |
| ROANOKE INSURANCE GROUP INC3 Filed as: ROANOKE GROUP, INC. | 1475 EAST WOODFIELD ROAD SUITE 500 SCHAUMBURG, IL 60173 | BLUECROSS BLUESHIELD OF ILLINOIS | — | $13 | $13 | 0.00% |
| MESIROW INSURANCE SERVICES INC3 | 353 NORTH CLARK CHICAGO, IL 60654 | BLUECROSS BLUESHIELD OF ILLINOIS | — | $8 | $8 | 0.00% |
| MESIROW INSURANCE SERVICES INC3 | 353 NORTH CLARK STREET SUITE 1100 CHICAGO, IL 60654 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $19K | $7K | $26K | 24.09% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INS SERVICES INC | 353 NORTH CLARK STREET CHICAGO, IL 60654 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | $4K | $12K | 15.51% |
| LYNN S LOPPNOW3 Filed as: LYNN S. LOPPNOW | 4524 CAPSTAN DRIVE HOFFMAN ESTATES, IL 60192 | AFLAC | $386 | $76 | $462 | 2.29% |
| H HOWARD THOMSON3 | 65 PINE AVENUE SUITE 102 LONG BEACH, CA 90802 | AFLAC | $379 | — | $379 | 1.88% |
| DEAN R LOPPNOW3 Filed as: DEAN R. LOPPNOW | 4524 CAPSTAN DRIVE HOFFMAN ESTATE, IL 60192 | AFLAC | $355 | — | $355 | 1.76% |
| PATRICIA R OSTI3 | 2077 BANCROFT LANE MT PLEASANT, SC 29466 | AFLAC | $192 | — | $192 | 0.95% |
| KENNETH J. FEUERBORN3 | 1544 SOUTH KEMBLEY AVENUE PALATINE, IL 60067 | AFLAC | $127 | — | $127 | 0.63% |
| GEORGIANNA STOUT3 | 150 HARBOR DRIVE UNIT 370 SAUSALITO, CA 94966 | AFLAC | $89 | — | $89 | 0.44% |
| THEODORE C RAZATOS3 Filed as: THEODORE C. RAZATOS | 116 SURREY LANE SAN RAFAEL, CA 94903 | AFLAC | $79 | — | $79 | 0.39% |
| CLAY W CAMPBELL3 Filed as: CLAY W. CAMPBELL | 14720 LIBLEN AVENUE BELLFLOWER, CA 90706 | AFLAC | $68 | — | $68 | 0.34% |
| H J SAMAAN INC3 | 4415 WEST HARRISON STREET SUITE 503 HILLSIDE, IL 60162 | AFLAC | $36 | $20 | $56 | 0.28% |
| GEORGE WILLIAMS3 Filed as: GEORGE LOWNDES WILLIAMS | 208 GRAND PARK BOULEVARD CHARLESTON, SC 29492 | AFLAC | $51 | — | $51 | 0.25% |
| ALDEAN T PEARSON3 Filed as: ALDEAN T. PEARSON | 8134 MONTERRA RANCH DRIVE APARTMENT 3617 FORT WORTH, TX 76177 | AFLAC | $49 | — | $49 | 0.24% |
| KANDI M MCINTYRE3 Filed as: KANDI M. MCINTYRE | 2000 MALLORY LANE SUITE 130-378 FRANKLIN, TN 37067 | AFLAC | $41 | — | $41 | 0.20% |
| MARK D BARBIER3 Filed as: MARK D. BARBIER | 802 DEER TRAIL LANE OAK BROOK, IL 60523 | AFLAC | $15 | $20 | $35 | 0.17% |
| LA FREY AND ASSOCIATES INC3 | 4415 WEST HARRISON STREET HILLSIDE, IL 60162 | AFLAC | $13 | $20 | $33 | 0.16% |
| KAREN M HUGHES3 Filed as: KAREN M. HUGHES | 3120 NORTHEAST 47TH STREET FORT LAUDERDALE, FL 33308 | AFLAC | $31 | — | $31 | 0.15% |
| SHANNON L TROWBRIDGE3 | 126 CYPRESS VIEW ROAD GOOSE CREEK, SC 29445 | AFLAC | $31 | — | $31 | 0.15% |
| ELIZABETH G VAUGHAN & ASSOCIATES3 Filed as: ELIZABETH G. VAUGHAN & ASSOCIATES | 323 VINE AVENUE PARK RIDGE, IL 60068 | AFLAC | $29 | — | $29 | 0.14% |
| ADAM H MICHAELS3 Filed as: ADAM H. MICHAELS | 12121 WILSHIRE BOULEVARD SUITE 1000 LOS ANGELES, CA 90025 | AFLAC | $24 | — | $24 | 0.12% |
| STEVEN T SPEICHINGER3 Filed as: STEVEN T. SPEICHINGER | 210 KENT STREET WAUSAU, WI 54403 | AFLAC | $21 | — | $21 | 0.10% |
| LA FREY AND ASSOCIATES INC3 | 14466 SOUTH ELIZABETH LANE HOMER GLEN, IL 60491 | AFLAC | $21 | — | $21 | 0.10% |
| ROBERT H MURRAY3 Filed as: ROBERT L. ALLEY | 2411 SAVANNAH HIGHWAY CHARLESTON, SC 29414 | AFLAC | $18 | — | $18 | 0.09% |
| ADAM H MICHAELS3 Filed as: ADAM H MICHAELS & ASSOCIATES LTD | 12121 WILSHIRE BOULEVARD SUITE 1000 LOS ANGELES, CA 90025 | AFLAC | $15 | — | $15 | 0.07% |
| JULIE ATKINS3 | 165 GRAMERCY DRIVE SAN MATEO, CA 94402 | AFLAC | $12 | — | $12 | 0.06% |
| ANNA JANICE RUIZ3 | 351 CALIFORNIA STREET SUITE 450 SAN FRANCISCO, CA 94104 | AFLAC | $11 | — | $11 | 0.05% |
| REGINA E MARTINELLI3 Filed as: REGINA E. MARTINELLI | POST OFFICE BOX 946 FORESTVILLE, CA 95436 | AFLAC | $11 | — | $11 | 0.05% |
| C HARVEY KING3 Filed as: C. HARVEY KING | POST OFFICE BOX 45 WEST JEFFERSON, NC 28694 | AFLAC | $11 | — | $11 | 0.05% |
| TOMMY L JOHNSON JR3 Filed as: TOMMY L. JOHNSON JR. | 930 SOUTH KINGSLEY DRIVE LOS ANGELES, CA 90006 | AFLAC | $11 | — | $11 | 0.05% |
| ALLISON FARRIS WENDELBERGER3 | 1839 YGNACIO VALLEY ROAD SUITE 393 WALNUT CREEK, CA 94598 | AFLAC | $10 | — | $10 | 0.05% |
| JOHN D TYLER3 Filed as: JOHN D. TYLER | 130 DUCK HAWK WAY MARIETTA, SC 29661 | AFLAC | $10 | — | $10 | 0.05% |
| 22 INSURANCE GROUP INC3 | 22385 MISTY FALLS CIRCLE FRANKFORT, IL 60423 | AFLAC | $10 | — | $10 | 0.05% |
| GEOFFREY MALAIS3 | 16800 DEVONSHIRE STREET SUITE 220 GRANADA HILLS, CA 91344 | AFLAC | $9 | — | $9 | 0.04% |
| WHITE & COMPANY INSURANCE INC.3 Filed as: WHITE AND COMPANY INC | POST OFFICE BOX 70 SANTA MONICA, CA 90406 | AFLAC | $9 | — | $9 | 0.04% |
| NAKIA M BOPP3 Filed as: NAKIA M. BOPP | 1985 RIVIERA DRIVE SUITE 103-205 MT PLEASANT, SC 29464 | AFLAC | $9 | — | $9 | 0.04% |
| TOMMY L JOHNSON JR3 Filed as: TOMMY L. JOHNSON JR. | 11620 WILSHIRE BOUELVARD SUITE 210 LOS ANGELES, CA 90025 | AFLAC | $9 | — | $9 | 0.04% |
| BOBBY F STREI3 | 1631 NORTH MAPLE STREET BURBANK, CA 91505 | AFLAC | $8 | — | $8 | 0.04% |
| TOMMY L JOHNSON JR3 Filed as: TOMMY L. JOHNSON JR. | 9504 ALLENSWOOD ROAD RANDALLSTOWN, MD 21133 | AFLAC | $7 | — | $7 | 0.03% |
| JOSEPH A BUZZELLO3 | 9018 BALBOA BOULEVARD SUITE 254 NORTHRIDGE, CA 91325 | AFLAC | $5 | — | $5 | 0.02% |
| MAGAN M. EUBANKS3 Filed as: MAGAN M EUBANKS | 346 VIA COLINAS WESTLAKE VILLAGE, CA 91362 | AFLAC | $4 | — | $4 | 0.02% |
| KATHLEEN S HANSON3 Filed as: KATHLEEN S. HANSON | 2581 HILLCREST STREET SIGNAL HILL, CA 90755 | AFLAC | $3 | — | $3 | 0.01% |
| ROBERT I BARNES3 | 1424 SCALES STREET APARTMENT A RALEIGH, NC 27608 | AFLAC | $3 | — | $3 | 0.01% |
| ERIC BROGAN3 Filed as: ERIC E MILLER | 6631 FOX RIDGE CIRCLE DAVIDSON, NC 28036 | AFLAC | $2 | — | $2 | 0.01% |
| ALFRED RIETKERK3 | 3120 NORTHEAST 47TH STREET FT LAUDERDALE, FL 33308 | AFLAC | $2 | — | $2 | 0.01% |
| H J SAMAAN INC3 | 19W152 21ST PLACE LOMBARD, IL 60148 | AFLAC | $1 | — | $1 | 0.00% |
| CHARLES EDWARD PERRY3 | 12858 TORREY PINES DRIVE AUBURN, CA 95602 | AFLAC | $1 | — | $1 | 0.00% |
| TODD V MASON3 Filed as: TODD V. MASON | 6164 LAWRENCE STREET CYPRESS, CA 90630 | AFLAC | $1 | — | $1 | 0.00% |
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 | 192 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 194 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF ILLINOIS | 330 | $2.6M |
| Dental(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 109 | $97K |
| Vision(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 109 | $97K |
| Life insurance(2 contracts, 2 carriers) | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 191 | $126K |
| Short-term disability(2 contracts, 2 carriers) | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 191 | $126K |
| Long-term disability | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 191 | $106K |
| Other(3 contracts, 3 carriers) | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 192 | $126K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 330 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.