| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TASK INSURANCE GROUP, LLC3 | 1821 WALDEN OFFICE SQUARE SUITE 350 SCHAUMBURG, IL 60173 | PRINCIPAL LIFE INSURANCE COMPANY | $23K | $0 | $23K | 7.12% |
| TASK INSURANCE GROUP, LLC3 | 1821 WALDEN OFFICE SQUARE SUITE 350 SCHAUMBURG, IL 60173 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $0 | $5K | 13.17% |
| JOHNSON SCHAFF3 | 2124 WASHINGTON AVENUE WILMETTE, IL 60091 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $326 | $0 | $326 | 0.79% |
| MJ INSURANCE3 Filed as: SANTIAGO OCHOA AND VARIOUS AGENTS | 2120 EL PASEO, UNIT 308 HOUSTON, TX 77054 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $147 | $0 | $147 | 0.36% |
| REBECCA STERNBERG3 | 374 MILFORD ROAD DEERFIELD, IL 60015 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $146 | $0 | $146 | 0.35% |
| MICHAEL BLOCK3 | 16619 SOUTH PINECREEK DRIVE LOCKPORT, IL 60441 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $93 | $0 | $93 | 0.23% |
| DAVID TODD WEINSTEIN3 | 222 NORTH COLUMBUS DRIVE CHIGAGO, IL 60601 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $93 | $0 | $93 | 0.23% |
| LINDA CANTU3 | 902 WEST 12TH STREET FREEPORT, TX 77541 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $74 | $0 | $74 | 0.18% |
| TASK INSURANCE GROUP, LLC3 | 1821 WALDEN OFFICE SQUARE SUITE 350 SCHAUMBURG, IL 60173 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $3K | $0 | $3K | 9.02% |
| TASK INSURANCE GROUP, LLC3 | 1821 WALDEN OFFICE SQUARE SUITE 350 SCHAUMBURG, IL 60173 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $944 | $0 | $944 | 14.19% |
| JOHNSON SCHAFF3 | 2124 WASHINGTON AVENUE WILMETTE, IL 60091 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $57 | $0 | $57 | 0.86% |
| REBECCA STERNBERG3 | 374 MILFORD ROAD DEERFIELD, IL 60015 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $36 | $0 | $36 | 0.54% |
| MICHAEL BLOCK3 | 16619 SOUTH PINECREEK DRIVE LOCKPORT, IL 60441 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $16 | $0 | $16 | 0.24% |
| DAVID TODD WEINSTEIN3 | 222 NORTH COLUMBUS DRIVE CHICAGO, IL 60601 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $16 | $0 | $16 | 0.24% |
| J CASTELLANOS AND ASSOCIATES INC3 Filed as: J. CASTELLANOS AND ASSOCIATES, INC. | 7441 FIGURA DRIVE JUSTICE, IL 60458 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $12 | $0 | $12 | 0.18% |
| JORGE ALEJANDRO MONTEMAYOR3 Filed as: JORGE H. CASTELLANOS | 7441 FIGURA DRIVE JUSTICE, IL 60458 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.08% |
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 | 428 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 428 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 747 | $321K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 470 | $37K |
| Life insurance(3 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 747 | $369K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 747 | $321K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 747 | $321K |
| Other(3 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 747 | $369K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 747 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.