| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | PO BOX 4016 CHAMPAIGN, IL 618244016 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $28K | — | $28K | 2.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 580 N 4TH STREET SUITE 400 COLUMBUS, OH 43215 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 7.79% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 4016 CHAMPAIGN, IL 618244016 | EYEMED VISION CARE | $704 | — | $704 | 5.46% |
| USI INSURANCE SERVICES LLC3 Filed as: USI SERVICES NATIONAL, INC. | PO BOX 4016 CHAMPAIGN, IL 618244016 | EYEMED VISION CARE | $488 | — | $488 | 3.79% |
| MICHAEL PETERS & ASSOCIATES, INC.3 Filed as: MICHAEL PAUL PETERS | 3808 W SPRINGFIELD AVE SUITE D CHAMPAIGN, IL 61822 | ILLINOIS MUTUAL LIFE INSURANCE COMPANY | $1K | — | $1K | 12.74% |
| GARY WARE & ASSOC INC3 Filed as: GARY WARE & ASSOC | 7 DUNLAP CT SUITE #7 SAVOY, IL 61874 | ILLINOIS MUTUAL LIFE INSURANCE COMPANY | $208 | — | $208 | 2.15% |
| WILLIAM PRITCHARD3 | 3808 W SPRINGFIELD AVE SUITE D CHAMPAIGN, IL 61820 | ILLINOIS MUTUAL LIFE INSURANCE COMPANY | $82 | — | $82 | 0.85% |
| SCOTT ALLEN REMOLE3 | 7 DUNLAP CT SUITE #7 SAVOY, IL 61874 | ILLINOIS MUTUAL LIFE INSURANCE COMPANY | $38 | — | $38 | 0.39% |
| DAVID THOMAS KEENAN3 | 3808 W SPRINGFIELD AVE SUITE D CHAMPAIGN, IL 61822 | ILLINOIS MUTUAL LIFE INSURANCE COMPANY | $8 | — | $8 | 0.08% |
| BENJAMIN JOSEPH MEYER3 | 7 DUNLAP CT SUITE 7 SAVOY, IL 61874 | ILLINOIS MUTUAL LIFE INSURANCE COMPANY | $7 | — | $7 | 0.07% |
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 | 230 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 233 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 200 | $1.4M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 229 | $110K |
| Vision | EYEMED VISION CARE | 183 | $13K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 229 | $110K |
| Short-term disability | ILLINOIS MUTUAL LIFE INSURANCE COMPANY | 98 | $10K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 229 | $110K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 229 | $110K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 229 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.