| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| R W GARRETT AGENCY3 Filed as: RW GARRETT AGENCY INC | 2201 WOODLAWN RD LINCOLN, IL 62656 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $11K | $878 | $12K | 0.87% |
| MIDWESTERN INS ASSOC AGY INC3 | PO BOX 410 MINIER, IL 617590451 | HUMANA | $6K | $3K | $9K | 8.48% |
| MIDWESTERN INS ASSOC AGY INC3 Filed as: MIDWESTERN INS ASSOC AGY | 120 S MAIN ST MINIER, IL 61759 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | — | $4K | 12.31% |
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 | 174 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 175 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 284 | $1.4M |
| Dental | HUMANA | 167 | $101K |
| Vision | HUMANA | 167 | $101K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 436 | $29K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ILLINOIS | 284 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 436 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.