| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PALABE & ASSOCIATES LTD3 | 501 N RIVERSIDE DR, STE #117 GURNEE, IL 60031 | BLUECROSS BLUESHIELD OF ILLINOIS | $59K | $765 | $60K | 3.90% |
| PALABE & ASSOCIATES LTD3 | 501 N RIVERSIDE DR STE 11 GURNEE, IL 60031 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $10K | — | $10K | 9.92% |
| PALABE & ASSOCIATES LTD3 | 501 N RIVERSIDE DRIVE STE 117 GURNEE, IL 60031 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 10.00% |
| PALABE & ASSOCIATES LTD3 Filed as: PALABE & ASSOCIATES, LTD. | 501 N RIVERSIDE DR, STE #117 GURNEE, IL 60031 | VISION SERVICE PLAN | $894 | — | $894 | 6.35% |
| PALABE & ASSOCIATES LTD3 | 501 N RIVERSIDE DRIVE STE 117 GURNEE, IL 60031 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 10.00% |
| PALABE & ASSOCIATES LTD3 | 501 N RIVERSIDE DRIVE STE 117 GURNEE, IL 60031 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $714 | — | $714 | 9.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPLOYEE BENEFITS CORPORATION EIN 39-2044064 CLAIMS PROCESSING | Contract Administrator; Claims processing Service code 12 | — | $5K |
| PALABE & ASSOCIATES, LTD BROKER | Insurance agents and brokers Service code 22 | 501 N RIVERSIDE DR STE #117 GURNEE, IL 60031 | $254 |
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 | 99 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 102 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 255 | $1.5M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 100 | $96K |
| Vision | VISION SERVICE PLAN | 100 | $14K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 148 | $27K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 105 | $10K |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 148 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 255 | — |
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.