| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ESSER HAYES INSURANCE GROUP3 Filed as: ESSER HAYES INSURANCE | 1811 HIGH GROVE, SUITE 139 NAPERVILLE, IL 60540 | HEALTH ALLIANCE MEDICAL PLANS | $67K | — | $67K | 13.79% |
| ASK BENEFIT SOLUTIONS INC3 | 1606 WILLOW VIEW RD STE 1R URBANA, IL 618027893 | PRINCIPAL LIFE INSURANCE COMPANY | $17K | — | $17K | 8.88% |
| CREATIVE MARKETING SOLUTIONS INC3 | 1609 YORKSHIRE DR CHAMPAIGN, IL 618227815 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | — | $2K | 1.07% |
| ASK BENEFIT SOLUTIONS INC3 | 2511 SCOVILL CIR URBANA, IL 61801 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $29 | $2K | 7.71% |
| CREATIVE MKTG SOLUTIONS INC3 | 108 HESSEL BLVD CHAMPAIGN, IL 61622 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $491 | — | $491 | 2.19% |
| DWIGHT GOSSETT3 | 13070 ABRAHAM RUN CARMEL, IN 46033 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $340 | — | $340 | 1.52% |
| JEFFREY LUXENBERG3 | 307 LONGTREE LANE LOGANSPORT, IN 46947 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | $68 | $101 | 0.45% |
| ROBERT WOODARD3 | 101 BOBWHITE DR WEBB CITY, MO 64870 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $42 | $42 | $84 | 0.37% |
| JEFFREY D BRINDLE3 | 10811 LAKEVIEW DRIVE CARMEL, IN 46033 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $60 | — | $60 | 0.27% |
| JOE GORDON3 | 5417 WINTHROP AVE INDIANAPOLIS, IN 46220 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.02% |
| DWIGHT GOSSETT3 | 13070 ABRAHAM RUN CARMEL, IN 46033 | AFLAC | $116 | — | $116 | 3.38% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 2107 S NEIL ST STE A CHAMPAIGN, IL 61820 | AFLAC | $87 | — | $87 | 2.53% |
| JAMES A SMAARDYK3 Filed as: JAMES SMAARDYK | 157 LONG MEADOW LN ROTONDA WEST, FL 33947 | AFLAC | $74 | — | $74 | 2.15% |
| EDWARD AYERS3 Filed as: EDWARD T AYERS | 817 BALBOA RD CHAMPAIGN, IL 61820 | AFLAC | $40 | — | $40 | 1.16% |
| ALICE GOSSETT3 Filed as: ALICE A GOSSETT | 13070 ABRAHAM RUN CARMEL, IN 46033 | AFLAC | $20 | — | $20 | 0.58% |
| HARRY HOAGLAND3 | 405 EVANS ST COVINGTON, IN 47932 | AFLAC | $17 | — | $17 | 0.49% |
| GLENN TADLOCK3 Filed as: GLENN E TADLOCK | 1461 PINE AVE RANTOUL, IL 61866 | AFLAC | $13 | — | $13 | 0.38% |
| RUSSELL THOMAS3 Filed as: RUSSELL F THOMAS | 611 E BROADWAY ST TOLONO, IL 61880 | AFLAC | $11 | — | $11 | 0.32% |
| JAMES H RAIRIGH3 Filed as: JAMES L SAVAGE | 574 TEAL LN TRAVERSE CITY, MI 49686 | AFLAC | $10 | — | $10 | 0.29% |
| CURTIS WHEAT3 | 507 HORSESHOE LN CASEY, IL 62420 | AFLAC | $5 | — | $5 | 0.15% |
| WILLIAM B KRZCIOK3 | 2760 FORT MYER AVE HENDERSON, NV 89052 | AFLAC | $2 | — | $2 | 0.06% |
| JAMES M BROCK3 | 1501 SANDBAR DR MARION, IL 62959 | AFLAC | $1 | — | $1 | 0.03% |
| CREATIVE MARKETING SOLUTIONS INC3 | 108 HESSEL BLVD STE 202 CHAMPAIGN, IL 61820 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $142 | — | $142 | 10.02% |
| WESLEY D. AMORE3 Filed as: WESLEY D AMORE | 3676 TUPELO RD VALDOSTA, GA 31605 | AFLAC | $34 | — | $34 | 5.90% |
| HARRY HOAGLAND3 Filed as: HARRY H HOAGLAND | 405 EVANS ST COVINGTON, IN 47932 | AFLAC | $19 | — | $19 | 3.30% |
| JAMES A SMAARDYK3 | 157 LONG MEADOW LN ROTONDA WEST, FL 33947 | AFLAC | $12 | — | $12 | 2.08% |
| ELAINE A WRINKLE3 Filed as: ELAINE WRINKLE | 404 TICKSEED AVE SAVOY, IL 61874 | AFLAC | $5 | — | $5 | 0.87% |
| JOSEPH FEJES3 | PO BOX 7767 CHAMPAIGN, IL 61826 | AFLAC | $1 | — | $1 | 0.17% |
| MISHA PORTER3 Filed as: MISHA D PORTER | 275 E COURT ST STE 208 KANKAKEE, IL 60901 | AFLAC | $1 | — | $1 | 0.17% |
| TERRY SILVERS3 | 100 GREENLEAF DR FLAT ROCK, NC 28731 | AFLAC | $0 | — | $0 | 0.00% |
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 | 219 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 57 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 276 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH ALLIANCE MEDICAL PLANS | 233 | $487K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 316 | $191K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 316 | $191K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 316 | $191K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 316 | $191K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 316 | $191K |
| Other(4 contracts, 3 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 46 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 316 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.