| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CLEMENS & ASSOCIATES LIFE AGENCY3 Filed as: CLEMENS AND ASSOCIATES LIFE | AGENCY, INC. 2806 E EMPIRE ST BLOOMINGTON, IL 61704 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $44K | $12K | $57K | 5.94% |
| CLEMENS & ASSOCIATES LIFE AGENCY3 Filed as: CLEMENS AND ASSOCIATES LIFE | AGENCY, INC. 2806 E EMPIRE ST BLOOMINGTON, IL 61702 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $36K | $0 | $36K | 15.00% |
| CLEMENS & ASSOCIATES LIFE AGENCY3 Filed as: CLEMENS AND ASSOCIATES LIFE | AGENCY, INC. 2806 E EMPIRE ST BLOOOMINGTON, IL 61702 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $35K | $0 | $35K | 15.00% |
| CLEMENS & ASSOCIATES LIFE AGENCY3 Filed as: CLEMENS AND ASSOCIATES LIFE | AGENCY, INC. 2806 E EMPIRE ST BLOOMINGTON, IL 61702 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $15K | $0 | $15K | 10.00% |
| CLEMENS & ASSOCIATES LIFE AGENCY3 Filed as: CLEMENS AND ASSOCIATES LIFE | AGENCY, INC. 2806 E EMPIRE ST BLOOMINGTON, IL 61704 | EYEMED VISION CARE | $7K | $0 | $7K | 5.02% |
| CLEMENS & ASSOCIATES LIFE AGENCY3 Filed as: CLEMENS AND ASSOCIATES LIFE | AGENCY, INC. 2806 E EMPIRE ST BLOOMINGTON, IL 61702 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $16K | $2K | $18K | 22.14% |
| CLEMENS & ASSOCIATES LIFE AGENCY3 Filed as: CLEMENS AND ASSOCIATES LIFE | AGENCY, INC. 2806 E EMPIRE ST BLOOMINGTON, IL 61702 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $15K | $2K | $16K | 22.09% |
| CLEMENS & ASSOCIATES LIFE AGENCY3 Filed as: CLEMENS AND ASSOCIATES LIFE | AGENCY, INC. 2806 E EMPIRE ST BLOOMINGTON, IL 61702 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $14K | $1K | $15K | 22.04% |
| CLEMENS & ASSOCIATES LIFE AGENCY3 Filed as: CLEMENS AND ASSOCIATES LIFE | AGENCY, INC. 2806 E EMPIRE ST BLOOMINGTON, IL 61704 | METLIFE LEGAL PLANS, INC. | $4K | $0 | $4K | 10.70% |
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 | 2,321 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,330 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,509 | $613K |
| Vision | EYEMED VISION CARE | 1,980 | $136K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,321 | $232K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 784 | $242K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 836 | $149K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF ILLINOIS | 1,648 | $952K |
| Other(5 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,321 | $270K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,321 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.