| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MEDLEY GROUP LTD3 | 1503 TRENTON LANE BARTLETT, IL 60103 | BLUE CROSS BLUE SHIELD | $91K | — | $91K | 2.65% |
| MEDLEY GROUP LTD3 | 1503 TRENTON LANE BARTLETT, IL 60103 | FIDELITY SECURITY LIFE INSURANCE CO. | $14K | — | $14K | 5.68% |
| MEDLEY GROUP LTD3 | 1503 TRENTON LANE BARTLETT, IL 60103 | GUARDIAN LIFE INSURANCE CO. OF AMERICA | $5K | — | $5K | 5.00% |
| MEDLEY GROUP LTD3 | 1503 TRENTON LANE BARTLETT, IL 60103 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 10.40% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| YESEAN NELSON EIN 36-4250648 EMPLOYEE | Employee (plan) Service code 30 | — | $56K |
| TAVIONA JOHNSON EIN 36-4250648 EMPLOYEE | Employee (plan) Service code 30 | — | $54K |
| SECURITY PROGRAMS INC EIN 36-2728094 NONE | Consulting (general) Service code 16 | — | $18K |
| CALIBRE CPA GROUP EIN 47-0900880 NONE | Accounting (including auditing) Service code 10 | — | $14K |
| LAW OFFICE OF JOSEPH GLIMCO EIN 36-4064225 BROTHER OF UNION TRUSTEE | Legal Service code 29 | — | $6K |
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 | 3,700 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 3,700 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD | 563 | $3.4M |
| Dental | GUARDIAN LIFE INSURANCE CO. OF AMERICA | 142 | $96K |
| Vision | FIDELITY SECURITY LIFE INSURANCE CO. | 4,277 | $239K |
| Life insurance | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 306 | $19K |
| Other | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 306 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,277 | — |
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.