| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CIBC OF ILLINOIS INC3 | PO BOX 71 KANKAKEE, IL 60901 | COVENTRY HEALTH CARE OF ILLINOIS | $73K | — | $73K | 15.08% |
| CIBC OF ILLINOIS INC3 Filed as: CIBC OF ILLINOIS | PO BOX 71 KANKAKEE, IL 60901 | PRINCIPAL LIFE INSURANCE COMPANY | $9K | $1K | $10K | 6.44% |
| CENTRAL ILLINOIS BENEFIT CONSULTANT3 | PO BOX 71 KANKAKEE, IL 60901 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $9K | — | $9K | 8.01% |
| BSP GROUP BENEFITS INC3 | 206 S JEFFERSON STREET, SUITE 200 CHICAGO, IL 60661 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $5K | — | $5K | 5.00% |
| ERIN BRZOZOWSKI, INC.3 Filed as: ERIN BRZOZOWSKI | 2 LIBERTY DR LEMONT, IL 60439 | AFLAC | $7K | $827 | $8K | 9.22% |
| CIBC OF ILLINOIS INC3 | PO BOX 71 KANKAKEE, IL 60901 | AFLAC | $3K | — | $3K | 3.77% |
| STEPHEN KELLS3 | 514 MAYFAIR COURT GERMANTOWN HILLS, IL 61548 | AFLAC | $1K | $24 | $1K | 1.78% |
| JEFF LAMBERT3 | 15419 W 127TH ST LEMONT, IL 60439 | AFLAC | $1K | — | $1K | 1.24% |
| JEREMY M SKEETERS3 Filed as: JEREMY SKEETERS | 23645 N 55TH DR GLENDALE, AZ 85310 | AFLAC | $646 | $138 | $784 | 0.95% |
| ERIN BRZOZOWSKI, INC.3 Filed as: ERIN BRZOZOWSKI | 2 LIBERTY DR LEMONT, IL 60439 | AFLAC | $629 | $119 | $748 | 0.90% |
| TIMOTHY ASBY3 | 9247 N MERIDIAN ST STE 205 INDIANAPOLIS, IN 46260 | AFLAC | $692 | $24 | $716 | 0.86% |
| ROBERT VESTAL3 | PO BOX 1240 DELAND, FL 32721 | AFLAC | $575 | — | $575 | 0.69% |
| TAMMY KILGORE3 | 2209 BELLA FIORE LN PONTIAC, IL 61764 | AFLAC | $485 | — | $485 | 0.58% |
| ROBERT STALTER3 | 3714 AUBURNDALE AVE THE VILLAGES, FL 32162 | AFLAC | $348 | — | $348 | 0.42% |
| MARK D BARBIER3 | 802 DEER TRAIL LN OAK BROOK, IL 60523 | AFLAC | $196 | $138 | $334 | 0.40% |
| CHRISTINE L BREWSTER3 Filed as: CHRISTINE BREWSTER | 2025 MAINE ST QUINCY, IL 62301 | AFLAC | $241 | — | $241 | 0.29% |
| DWIGHT GOSSETT3 | 13070 ABRAHAM RUN CARMEL, IN 46033 | AFLAC | $188 | — | $188 | 0.23% |
| RETHA GOODWIN3 | 705 E. ELMO CT GODLEY, IL 60407 | AFLAC | $187 | — | $187 | 0.23% |
| LYNNETTE E COX3 | PO BOX 265 WAUNAKEE, WI 53597 | AFLAC | $185 | — | $185 | 0.22% |
| ROBERT VESTAL3 | PO BOX 957318 HOFFMAN ESTATES, IL 60195 | AFLAC | $164 | — | $164 | 0.20% |
| JAMES A SMAARDYK3 Filed as: JAMES SMAARDYK | 2831 CEDAR HILLS LANE TWIN LAKE, MI 49457 | AFLAC | $133 | — | $133 | 0.16% |
| GARY W WARE JR3 Filed as: GARY WARE JR | 2306 VALLEYBROOK DR CHAMPAIGN, IL 61822 | AFLAC | $125 | — | $125 | 0.15% |
| JEFF LAMBERT3 | 15419 W. 127TH STREET LEMONT, IL 60439 | AFLAC | $97 | $24 | $121 | 0.15% |
| GARY W WARE JR3 Filed as: GARY WARE JR | 2306 VALLEYBROOK DR CHAMPAIGN, IL 61822 | AFLAC | $102 | — | $102 | 0.12% |
| KENT HORSMAN3 | 14162 LADUE RD CHESTERFIELD, MO 63017 | AFLAC | $89 | — | $89 | 0.11% |
| MARK SHIFMAN3 | 6517 DENNY AVE NORTH HOLLYWOOD, CA 91606 | AFLAC | $86 | — | $86 | 0.10% |
| THOMAS MCGINN3 | 25470 PROPHET ROAD ROCK FALLS, IL 61071 | AFLAC | $74 | — | $74 | 0.09% |
| THOMAS J. ROSENGREN3 | 1807 22ND AVE STERLING, IL 61081 | AFLAC | $71 | — | $71 | 0.09% |
| KENNETH P BORDERS3 | 1308 W WAHALLA LANE PHOENIX, AZ 85027 | AFLAC | $71 | — | $71 | 0.09% |
| DENNIS J CASSENS3 Filed as: DENNIS CASSENS | 3422 COLONY BAY DRIVE ROCKFORD, IL 61109 | AFLAC | $67 | — | $67 | 0.08% |
| KACY A GRUENKEMEYER3 Filed as: KACY GRUENKEMEYER | 11116 AURORA AVE URBANDALE, IA 50322 | AFLAC | $58 | — | $58 | 0.07% |
| SHERRI L KALB3 | 31 PINE CT MONTROSE, IA 52639 | AFLAC | $51 | — | $51 | 0.06% |
| TINA M LASSUY3 Filed as: TINA M. LASSUY | 3021 45TH ST MOLINE, IL 61265 | AFLAC | $43 | — | $43 | 0.05% |
| DOROTHY REYNOLDS3 | 2302 S RACE ST URBANA, IL 61801 | AFLAC | $40 | — | $40 | 0.05% |
| LARRY E ABBE3 Filed as: LARRY ABBE | PO BOX 268 BUCKLEY, IL 60918 | AFLAC | $37 | — | $37 | 0.04% |
| LORI ANN NEWBERRY3 | 3071 175TH AVENUE ARGYLE, IA 52619 | AFLAC | $35 | — | $35 | 0.04% |
| SARAH SPEARS3 | 8371 CENTER DR LANARK, IL 61046 | AFLAC | $34 | — | $34 | 0.04% |
| ELIZABETH M GASPAROVIC3 Filed as: ELIZABETH GASPAROVIC | 1531 W RUE JAMES PL PALATINE, IL 60067 | AFLAC | $32 | — | $32 | 0.04% |
| CHAD L NELSON3 Filed as: CHAD NELSON | 490 EAST ROOSEVELT ROAD STE 203 WEST CHICAGO, IL 60185 | AFLAC | $31 | — | $31 | 0.04% |
| SHERRI L KALB3 Filed as: SHERRI KALB | 27 S 14TH STREET KEOKUK, IA 52632 | AFLAC | $23 | — | $23 | 0.03% |
| AARON WELLBAUM3 | 20022 N 800TH ST JEWETT, IL 62467 | AFLAC | $19 | — | $19 | 0.02% |
| TINA M LASSUY3 Filed as: TINA LASSUY | 1523 47TH AVE MOLINE, IL 61265 | AFLAC | $19 | — | $19 | 0.02% |
| JOHN D LASSUY3 Filed as: JOHN LASSUY | 4544 3RD STREET MOLINE, IL 61265 | AFLAC | $18 | — | $18 | 0.02% |
| JAMES H RAIRIGH3 Filed as: JAMES SAVAGE | 7159 CHERRYWOOD CT TRAVERSE CITY, MI 49686 | AFLAC | $15 | — | $15 | 0.02% |
| ALAN FILLIGER3 | 2250 NW 114TH AVE UNIT 1P MIAMI, FL 33172 | AFLAC | $15 | — | $15 | 0.02% |
| JUDY PALS3 | 210 N OAK PO BOX 432 TEUTOPOLIS, IL 62467 | AFLAC | $14 | — | $14 | 0.02% |
| FRANCES R WYNDHAM3 | 1101 WEST PARK AVE BRAZIL, IN 47834 | AFLAC | $13 | — | $13 | 0.02% |
| LESTER E WILSON3 | 211 E 3RD ST PROPHETSTOWN, IL 61277 | AFLAC | $12 | — | $12 | 0.01% |
| RAWLYN R ROSS3 | 219 AVONLEA PL JOHNSON CITY, TN 37604 | AFLAC | $10 | — | $10 | 0.01% |
| LEE KRAUS3 Filed as: LEE J. KRAUS | 1382 IRONWOOD DR LEBANON, OH 45036 | AFLAC | $9 | — | $9 | 0.01% |
| RUSSELL THOMAS3 | 800 W CHURCH ST APT 1 CHAMPAIGN, IL 61820 | AFLAC | $9 | — | $9 | 0.01% |
| BRIAN P BUTZ3 Filed as: BRIAN BUTZ | 96 WOODS EDGE CT WEST LAFAYETTE, IN 47906 | AFLAC | $8 | — | $8 | 0.01% |
| JOHN L RADTKE3 Filed as: JOHN RADTKE | 88 PENRIDGE CT LAFAYETTE, IN 47905 | AFLAC | $8 | — | $8 | 0.01% |
| GARY W JOHNSON3 Filed as: GARY W. JOHNSON | 802 LITTLE CREEK RD ANDERSON, SC 29621 | AFLAC | $8 | — | $8 | 0.01% |
| MITCHELL J MCCALL3 | 1620 WILLINGTON APT 101 BEAUMONT, TX 77706 | AFLAC | $8 | — | $8 | 0.01% |
| TERRY SILVERS3 | 100 GREENLEAF DR FLAT ROCK, NC 28731 | AFLAC | $7 | — | $7 | 0.01% |
| AARON J DUNNILL3 | 275 E COURT ST STE 208 KANKAKEE, IL 60901 | AFLAC | $6 | — | $6 | 0.01% |
| N BLAINE HARDACRE3 | 11671 GRANGE ROAD LANARK, IL 61046 | AFLAC | $6 | — | $6 | 0.01% |
| MICHAEL E MCCARTHY3 | PO BOX 1047 DUNDEE, IL 60118 | AFLAC | $5 | — | $5 | 0.01% |
| ANGELA R CONDON3 Filed as: ANGELA CONDON | PO BOX 820 ROCHESTER, IN 46975 | AFLAC | $3 | — | $3 | 0.00% |
| MALINDA BARTECK3 | 26110 GARDEN RD FARMER CITY, IL 61842 | AFLAC | $3 | — | $3 | 0.00% |
| TRACI R BATTEN3 Filed as: TRACI BATTEN | 144 BRIDGEFORT CT ROCKY MOUNTAIN, NC 27804 | AFLAC | $3 | — | $3 | 0.00% |
| WILLIAM MCFALLS3 | 902 W 23RD ST STERLING, IL 61081 | AFLAC | $2 | — | $2 | 0.00% |
| VICKI KAU3 | 906 PROGRESSIVE LANE MADISON, WI 53716 | AFLAC | $2 | — | $2 | 0.00% |
| CURTIS WHEAT3 | 11145 N FRIENDSHIP ROAD MARTINSVILLE, IL 62442 | AFLAC | $2 | — | $2 | 0.00% |
| JOHN HARNISH3 | PO BOX 218 LENA, IL 61048 | AFLAC | $2 | — | $2 | 0.00% |
| WILLIAM B KRZCIOK3 Filed as: WILLIAM KRZCIOK | 2760 FORT MEYER AVE HENDERSON, NV 89052 | AFLAC | $1 | — | $1 | 0.00% |
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN GLAUB | 54369 30TH ST SOUTH BEND, IN 46563 | AFLAC | $1 | — | $1 | 0.00% |
| MICHAEL A ORTIZ3 Filed as: MICHAEL ORTIZ | 3433 VOLTAIRE LANE ST CHARLES, IL 60175 | AFLAC | $1 | — | $1 | 0.00% |
| MICHAEL E MILLARD3 Filed as: MICHAEL MILLARD | W3648 SCOTCH BUSH RD ELKHORN, WI 53121 | AFLAC | $1 | — | $1 | 0.00% |
| GLEN T SCHWEIKERT3 | 2211 HIGHLAND SPRINGS PL LOUISVILLE, KY 40245 | AFLAC | $1 | — | $1 | 0.00% |
| MARY HANNIG3 Filed as: MARY HANNING | 725 STRAFFORD RIDGE DR BALLWIN, MO 63021 | AFLAC | $0 | — | $0 | 0.00% |
| MELISSA ANN ROUSE3 | 1210 COURTLAND TER WAUCONDA, IL 60084 | AFLAC | $0 | — | $0 | 0.00% |
| CIBC OF ILLINOIS INC3 Filed as: CIBC OF ILLINOIS, INC | 187 S SCHUYLER SUITE 500 KANKAKEE, IL 60901 | CONTINENTAL AMERICAN INSURANCE COMPANY | $11K | — | $11K | 22.97% |
| MISHA PORTER3 | 565 WILSON DR CLIFTON, IL 60927 | CONTINENTAL AMERICAN INSURANCE COMPANY | $9K | — | $9K | 17.67% |
| BARRY MONTALTA3 | PO BOX 181 RALEIGH, IL 62977 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6K | — | $6K | 12.51% |
| JASON E COX3 Filed as: JASON COX | 308 S COURT ST MARION, IL 62959 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 4.79% |
| TRAVIS COCKBURN3 | 402 N MAIN ST BENTON, IL 62812 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 4.55% |
| TIMOTHY INGRAM3 | 2105 EASTLAND DR STE 13 BLOOMINGTON, IL 61704 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 3.17% |
| JEREMY S KLOKKENGA3 | 1355 N BLUFF ROAD SUITE A COLLINSVILLE, IL 62234 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 3.09% |
| JASON HOFFARD3 | 402 N MAIN BENTON, IL 62812 | CONTINENTAL AMERICAN INSURANCE COMPANY | $380 | — | $380 | 0.76% |
| MARTHA MONCKTON3 | 2411 E GRANDVIEW AVE PEORIA, IL 61614 | CONTINENTAL AMERICAN INSURANCE COMPANY | $380 | — | $380 | 0.76% |
| NICOLE ROSENDAHL3 | 275 E COURT ST SUITE 208 KANKAKEE, IL 60901 | CONTINENTAL AMERICAN INSURANCE COMPANY | $29 | — | $29 | 0.06% |
| CIBC OF ILLINOIS INC3 Filed as: CIBC OF ILLINOIS | PO BOX 71 KANKAKEE, IL 60901 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | $196 | $2K | 14.08% |
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 | 473 | 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) | 476 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COVENTRY HEALTH CARE OF ILLINOIS | 476 | $481K |
| Dental | AMERICAN GENERAL LIFE INSURANCE COMPANY | 167 | $106K |
| Life insurance(2 contracts, 2 carriers) | AMERICAN GENERAL LIFE INSURANCE COMPANY | 838 | $119K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 351 | $154K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 351 | $154K |
| Stop-loss / reinsurancereinsurance | COVENTRY HEALTH CARE OF ILLINOIS | 476 | $481K |
| Other(3 contracts, 3 carriers) | AMERICAN GENERAL LIFE INSURANCE COMPANY | 167 | $239K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 838 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.