| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LEDGESTONE INSURANCE GROUP INC3 | 410 N MAIN STREET EAST PEORIA, IL 61611 | BLUECROSS BLUESHIELD OF ILLINOIS | $94K | — | $94K | 3.89% |
| LEDGESTONE INSURANCE GROUP INC3 Filed as: LEDGESTONE INSURANCE GROUP, INC | 410 N MAIN ST EAST PEORIA, IL 61611 | RELIANCE MATRIX | $13K | — | $13K | 10.00% |
| MGIS3 | 111 SOUTH MAIN STREET, SUITE 400 SALT LAKE CITY, UT 841112176 | RELIANCE MATRIX | — | $135 | $135 | 0.10% |
| LEDGESTONE INSURANCE GROUP INC3 | 410 N MAIN STREET EAST PEORIA, IL 61611 | DEARBORN LIFE INSURANCE COMPANY | $2K | — | $2K | 11.73% |
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 | 194 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 196 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 275 | $2.4M |
| Dental | BLUECROSS BLUESHIELD OF ILLINOIS | 275 | $2.4M |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 198 | $17K |
| Short-term disability | RELIANCE MATRIX | 190 | $131K |
| Other | DEARBORN LIFE INSURANCE COMPANY | 198 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 275 | — |
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.