| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MESIROW INSURANCE SERVICES INC3 | 353 N CLARK ST #1100 CHICAGO, IL 60654 | HEALTH NET | $18K | — | $18K | 3.60% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT | — | BLUECROSS BLUESHIELD OF ILLINOIS | — | $1K | $1K | 0.27% |
| DICK BLICK HOLDINGS, INC. DBA BLICK3 Filed as: DICK BLICK HOLDINGS, INC. | DBA BLICK ART MATERIALS 695 US HIGHWAY 150 E GALESBURG, IL 61402 | BLUECROSS BLUESHIELD OF ILLINOIS | — | $14 | $14 | 0.00% |
| MESIROW INSURANCE SERVICES INC3 | 353 N CLARK CHICAGO, IL 60654 | BLUECROSS BLUESHIELD OF ILLINOIS | — | $5 | $5 | 0.00% |
| MESIROW INSURANCE SERVICES INC3 | 353 N CLARK ST CHICAGO, IL 60654 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 990.80% |
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 | 1,001 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,001 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH NET | 92 | $925K |
| Dental | DELTA DENTAL OF ILLINOIS | 840 | $38K |
| Life insurance(5 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,001 | $133K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,001 | $126K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,001 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,001 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.