| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: DIMOND BROS INSURANCE LLC | 110 W COURT STREET PO BOX 1090 PARIS, IL 619445090 | DELTA DENTAL OF ILLINOIS | $10K | — | $10K | 4.62% |
| ASSUREDPARTNERS3 Filed as: DIMOND BROS INSURANCE LLC | 110 W COURT STREET PO BOX 1090 PARIS, IL 619445090 | DEARBORN LIFE INSURANCE COMPANY | $22K | — | $22K | 15.00% |
| ASSUREDPARTNERS3 Filed as: DIMOND BROS INSURANCE LLC | 110 W COURT ST PARIS, IL 61944 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 3.25% |
| AARON VANPELT INC2 | 755 W CARMEL DR CARMEL, IN 46032 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $114 | $1K | 2.16% |
| HR CLOUD LLC3 | 1050 EAST 86TH ST INDIANAPOLIS, IN 46240 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $992 | — | $992 | 1.49% |
| JANTELLE LAVONNE BONNER3 | 974 ROSEFIELD LANE AURORA, IL 60504 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $314 | $399 | $713 | 1.07% |
| DAVID J MCCLELLAN3 Filed as: DAVID GORDON EARL | 289 REDWOOD AVE ELK GROVE VILLAGE, IL 60007 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $689 | — | $689 | 1.03% |
| MATTHEW E. RYDELL3 Filed as: MATTHEW E RYDELL | 7113 KINGSWOOD CT INDIANAPOLIS, IN 46256 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $394 | — | $394 | 0.59% |
| ELAISIUS BONNER3 | 974 ROSEFIELD LANE AURORA, IL 60504 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $150 | $177 | $327 | 0.49% |
| LEONARD L CAVENDER3 | 12650 WINDHAM PASS CARMEL, IN 46032 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $246 | — | $246 | 0.37% |
| FELTER INC3 | 5403 COMMONWEALTH AVE WESTERN SPRINGS, IL 60558 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $240 | — | $240 | 0.36% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: STACY J BROWN | 412 S CHANNEL DR ROUND LAKE BEACH, IL 60073 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $188 | — | $188 | 0.28% |
| ROBERT EARL PETERS3 | 307 GARDENDALE RD TERRE HAUTE, IN 47803 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $143 | $2 | $145 | 0.22% |
| MICHAEL BLOCK3 | 16619 S PINECREEK DRIVE LOCKPORT, IL 60441 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $108 | — | $108 | 0.16% |
| JOSHUA T JONES3 | 25 GARFIELD LN STREAMWOOD, IL 60107 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $51 | — | $51 | 0.08% |
| KRISTIN J QUINLAN3 Filed as: KRISTIN M JONES | 25 GARFIELD LN STREAMWOOD, IL 60107 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.02% |
| NATASHA PALMER3 | 2413 W ALGONQUIN RD, #115 ALGONQUIN, IL 60102 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $5 | $9 | 0.01% |
| DAVID TODD WEINSTEIN3 | 601 W JACKSON BLVD UNIT 912 CHICAGO, IL 60661 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.01% |
| JONAH LOWENTHAL3 | 1850 N CLARK ST CHICAGO, IL 60614 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| BILLY KIRKHAM3 | PO BOX 2701 TERRE HAUTE, IN 47802 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.00% |
| ASSUREDPARTNERS3 Filed as: DIMOND BROS. INSURANCE, LLC | PO BOX 1090 PARIS, IL 619445090 | VISION SERVICE PLAN | $1K | — | $1K | 3.66% |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF ILLINOIS | 413 | $219K |
| Vision | VISION SERVICE PLAN | 290 | $41K |
| Life insurance(2 contracts, 2 carriers) | DEARBORN LIFE INSURANCE COMPANY | 393 | $212K |
| Short-term disability | DEARBORN LIFE INSURANCE COMPANY | 393 | $145K |
| Other | DEARBORN LIFE INSURANCE COMPANY | 393 | $145K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 413 | — |
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.