| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BANK OF SPRINGFIELD3 | 2600 STEVENSON DRIVE SPRINGFIELD, IL 62703 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $33K | — | $33K | 1.01% |
| BANK OF SPRINGFIELD3 | 2600 STEVENSON DRIVE SPRINGFIELD, IL 62703 | DELTA DENTAL OF ILLINOIS | $18K | — | $18K | 6.87% |
| BANK OF SPRINGFIELD3 | 2600 STEVENSON DRIVE SPRINGFIELD, IL 62703 | UNUM LIFE INSURANCE COMPANY | $10K | — | $10K | 5.59% |
| BANK OF SPRINGFIELD3 | 2600 STEVENSON DRIVE SPRINGFIELD, IL 62703 | UNUM LIFE INSURANCE COMPANY | $10K | — | $10K | 13.88% |
| BANK OF SPRINGFIELD3 | 2600 STEVENSON DRIVE SPRINGFIELD, IL 62703 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 4.40% |
| BANK OF SPRINGFIELD3 | 2600 STEVENSON DRIVE SPRINGFIELD, IL 62703 | EYEMED | $1K | — | $1K | 5.01% |
| BANK OF SPRINGFIELD3 | 2600 STEVENSON DRIVE SPRINGFIELD, IL 62703 | UNUM INSURANCE COMPANY | $3K | — | $3K | 13.83% |
| BANK OF SPRINGFIELD3 | 2600 STEVENSON DRIVE SPRINGFIELD, IL 62703 | UNUM INSURANCE COMPANY | $2K | — | $2K | 13.83% |
| BANK OF SPRINGFIELD3 | 2600 STEVENSON DRIVE SPRINGFIELD, IL 62703 | UNUM INSURANCE COMPANY | $1K | — | $1K | 13.87% |
| BANK OF SPRINGFIELD3 | 2600 STEVENSON DRIVE SPRINGFIELD, IL 62703 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $131 | — | $131 | 14.97% |
| BANK OF SPRINGFIELD3 | 2600 STEVENSON DRIVE SPRINGFIELD, IL 62703 | EYEMED | $10 | — | $10 | 4.48% |
| BANK OF SPRINGFIELD3 | 2600 STEVENSON DRIVE SPRINGFIELD, IL 62703 | EYEMED | $10 | — | $10 | 5.26% |
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 | 340 | Currently employed and enrolled or eligible. |
| Retired/separated still eligible | 6 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 346 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 427 | $3.3M |
| Dental | DELTA DENTAL OF ILLINOIS | 262 | $268K |
| Vision(3 contracts) | EYEMED | 443 | $29K |
| Life insurance | UNUM LIFE INSURANCE COMPANY | 330 | $183K |
| Short-term disability(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY | 330 | $213K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY | 330 | $183K |
| Other(5 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY | 156 | $121K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 443 | — |
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."
No prospect flags tripped on this filing.