| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES, INC | 353 NORTH CLARK CHICAGO, IL 60654 | BLUECORSS BLUESHIELD OF ILLINOIS | $60K | — | $60K | 3.82% |
| MESIROW INSURANCE SERVICES INC3 | 353 NORTH CLARK STREET SUITE 1100 CHICAGO, IL 60654 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 5.93% |
| MESIROW INSURANCE SERVICES INC3 | 353 NORTH CLARK STREET SUITE 1100 CHICAGO, IL 60654 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $1K | $3K | 10.94% |
| MESIROW INSURANCE SERVICES INC3 | 353 NORTH CLARK STREET SUITE 1100 CHICAGO, IL 60654 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 20.97% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES, INC | 353 NORTH CLARK STREET SUITE 1100 CHICAGO, IL 60654 | VISION SERVICE PLAN | $2K | — | $2K | 9.98% |
| MESIROW INSURANCE SERVICES INC3 | 353 NORTH CLARK STREET SUITE 1100 CHICAGO, IL 60654 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 20.92% |
| MARTHA A DUBOIS3 | 8431 SOUTH 84TH AVENUE HICKORY HILLS, IL 60457 | AFLAC | $508 | — | $508 | 3.44% |
| MARTHA A DUBOIS3 | 8431 SOUTH 84TH AVENUE HICKORY HILLS, IL 60457 | AFLAC | $321 | $16 | $337 | 2.28% |
| HUERTA AND ASSOCIATES INC3 Filed as: HUERTA AND ASSOC INC | 9701 SOUTH 78TH AVENUE SUITE 202 HICKORY HILLS, IL 60457 | AFLAC | $252 | $3 | $255 | 1.73% |
| MESIROW INSURANCE SERVICES INC3 | 321 NORTH CLARK STREET CHICAGO, IL 60610 | AFLAC | $215 | — | $215 | 1.45% |
| LA FREY AND ASSOCIATES INC3 | 14466 SOUTH ELIZABETH LANE HOMER GLEN, IL 60491 | AFLAC | $208 | — | $208 | 1.41% |
| H J SAMAAN INC3 | 19W152 21ST PLACE LOMBARD, IL 60148 | AFLAC | $117 | — | $117 | 0.79% |
| MESIROW INSURANCE SERVICES INC3 | 321 NORTH CLARK STREET CHICAGO, IL 60654 | AFLAC | $108 | — | $108 | 0.73% |
| JOHN H VRATSINAS3 | 401 NORTH BIRCH ROAD UNITE 1112 FT LAUDERDALE, FL 33304 | AFLAC | $60 | — | $60 | 0.41% |
| WESTERMAYER AND ASSOCIATES LLC3 | 2164 AYLESPORT DRIVE DALLAS, TX 75001 | AFLAC | $54 | — | $54 | 0.37% |
| JEFFREY LYNN LAMBERT3 | 7 CENTER STREET HINSDALE, IL 60521 | AFLAC | $44 | $3 | $47 | 0.32% |
| MICHAEL ROBERT YURCZYK3 | 9516 WYOMING TERRACE SOUTH BLOOMINGTON, MN 55436 | AFLAC | $47 | — | $47 | 0.32% |
| ANNA ELIZABET RECCHIA3 | 401 NORTH BIRCH ROAD UNIT 1112 FT LAUDERDALE, FL 33304 | AFLAC | $33 | — | $33 | 0.22% |
| STEPHANIE R KLADIS3 | 7517 WEST HANOVER STREET SUMMIT ARGO, IL 60501 | AFLAC | $21 | — | $21 | 0.14% |
| ROBERT G MURPHY3 | 3240 ANTON DRIVE AURORA, IL 60504 | AFLAC | $18 | — | $18 | 0.12% |
| TODD DEVOSS3 Filed as: TODD C DEVOSS | 321 NORTH CLARK STREET SUITE 625 CHICAGO, IL 60654 | AFLAC | $18 | — | $18 | 0.12% |
| JOSEPH A NASCA3 | 28081 WEST MAPLE AVENUE BARRINGTON, IL 60010 | AFLAC | $18 | — | $18 | 0.12% |
| ANNA ELIZABET RECCHIA3 | 7 SOUTH ABERDEEN STREET APARTMENT 2C CHICAGO, IL 60507 | AFLAC | $16 | — | $16 | 0.11% |
| SANDRA SOLDAT3 | 732 7TH AVENUE LA GRANGE, IL 60525 | AFLAC | $12 | — | $12 | 0.08% |
| MARK D BARBIER3 | 23 CROYDON LANE OAK BROOK, IL 60523 | AFLAC | $11 | — | $11 | 0.07% |
| JOHN H VRATSINAS3 | 2821 NORTH OCEAN BOULEVARD APPARTMENT 305 FT LAUDERDALE, FL 33308 | AFLAC | $6 | — | $6 | 0.04% |
| ANNA ELIZABET RECCHIA3 | 100 WEST CYPRESS CREEK ROAD SUITE 630 FT LAUDERDALE, FL 33309 | AFLAC | $5 | — | $5 | 0.03% |
| BARBIER GROUP INC3 | 414 NORTH ORLEANS STREET SUITE 601 CHICAGO, IL 60654 | AFLAC | $2 | — | $2 | 0.01% |
| ELIZABETH M GASPAROVIC3 | 18 NORTH SMITH STREET PALATINE, IL 60067 | AFLAC | $2 | — | $2 | 0.01% |
| JOHN H VRATSINAS3 | 1142 WEST MADISON STREET UNIT 305 CHICAGO, IL 60607 | AFLAC | $2 | — | $2 | 0.01% |
| GREGORY SHARP3 | 702 EAST 5TH STREET COAL VALLEY, IL 61240 | AFLAC | $1 | — | $1 | 0.01% |
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 | 113 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 115 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECORSS BLUESHIELD OF ILLINOIS | 258 | $1.6M |
| Dental | DELTA DENTAL OF ILLINOIS | 109 | $125K |
| Vision | VISION SERVICE PLAN | 109 | $17K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 113 | $17K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 113 | $36K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 113 | $23K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 113 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 258 | — |
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.