| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MID ILLINOIS INSURANCE SERVICES INC3 Filed as: MID ILLINOIS INSURANCE | 1524 W GLEN AVE SUITE B PEORIA, IL 61614 | BLUE CROSS BLUE SHIELD | $62K | $23 | $62K | 3.53% |
| UFTRING DEALERSHIPS | 1860 WASHINGTON ROAD WASHINGTON, IL 61571 | BLUE CROSS BLUE SHIELD | — | $22 | $22 | 0.00% |
| MID ILLINOIS INSURANCE SERVICES INC3 Filed as: MID ILLINOIS INSURANCE | 1524 W GLEN AVE SUITE B PEORIA, IL 61614 | AFLAC | $2K | — | $2K | 3.99% |
| JUDITH HAEFLINGER3 | 16135 MALBEC ST FISHERS, IN 46037 | AFLAC | $868 | — | $868 | 1.90% |
| ROGER THORNTON3 | 4402 W CAPRI CT PEORIA, IL 61615 | AFLAC | $337 | — | $337 | 0.74% |
| LEGACY INSURANCE AGENCY3 | 89 EASTGATE DR WASHINGTON, IL 61571 | AFLAC | $258 | — | $258 | 0.57% |
| SCOTT A SMITH3 Filed as: SCOTT SMITH | 5300 OAKBROOK PKWY BLDG 300 STE 350 NORCROSS, GA 30093 | AFLAC | $230 | — | $230 | 0.50% |
| ROY TRIMBLE3 | 810 S JOHANSON RD PEORIA, IL 61607 | AFLAC | $229 | — | $229 | 0.50% |
| TYE ELLIOTT3 | 1300 N INDEPENDENCE CT GERMANTOWN HILLS, IL 61548 | AFLAC | $144 | — | $144 | 0.32% |
| L EDWARD LANTMAN3 | 2001 W WILLOW KNOLLS RD SUITE C PEORIA, IL 61614 | AFLAC | $134 | — | $134 | 0.29% |
| LORI A WALLACE3 Filed as: LORI WALLACE | 2001 W WILLOW KNOLLS DR STE 206 PEORIA, IL 61614 | AFLAC | $122 | — | $122 | 0.27% |
| ELIZABETH M GASPAROVIC3 Filed as: ELIZABETH GASPAROVIC | 1653 N BELMONT CT ARLINGTON HEIGHTS, IL 60004 | AFLAC | $119 | — | $119 | 0.26% |
| TOSHA MCQUEARY3 | 2214 W GLEN AVE PEORIA, IL 61614 | AFLAC | $117 | — | $117 | 0.26% |
| ROSEMARY TRIMBLE3 | 810 S JOHANSON RD PEORIA, IL 61607 | AFLAC | $115 | — | $115 | 0.25% |
| BRIAN ELLIOTT3 | 117 KAITLIN COURT EAST PEORIA, IL 61611 | AFLAC | $105 | — | $105 | 0.23% |
| JILL MURPHY3 | 3210 N SHERIDAN RD PEORIA, IL 61604 | AFLAC | $77 | — | $77 | 0.17% |
| MICHAEL E MCCARTHY3 Filed as: MICHAEL MCCARTHY | PO BOX 1047 DUNDEE, IL 60118 | AFLAC | $73 | — | $73 | 0.16% |
| MICHAEL A ORTIZ3 Filed as: MICHAEL ORTIZ | 3433 VOLTAIRE LANE ST CHARLES, IL 60175 | AFLAC | $68 | — | $68 | 0.15% |
| TERRY SILVERS3 | 100 GREENLEAF DR FLAT ROCK, NC 28731 | AFLAC | $64 | — | $64 | 0.14% |
| HANA M MUELLER3 Filed as: HANA MUELLER | PO BOX 283 STANFORD, IL 61774 | AFLAC | $60 | — | $60 | 0.13% |
| JENNIFER WOODRUM3 | 410 W. MARKET ST COLCHESTER, IL 62326 | AFLAC | $59 | — | $59 | 0.13% |
| CARLENE HIPPEN3 | 89 EASTGATE DRIVE WASHINGTON, IL 61571 | AFLAC | $44 | — | $44 | 0.10% |
| MARK L RHODES3 Filed as: MARK RHODES | 133A SOUTH MAIN ST MORTON, IL 61550 | AFLAC | $42 | — | $42 | 0.09% |
| BRENT GOODE3 | 301 MALLORY STATION RD SUITE 100 FRANKLIN, TN 37067 | AFLAC | $31 | — | $31 | 0.07% |
| CHRISTOPHER L ALTON3 Filed as: CHRISTOPHER ALTON | 150 N MILLER RD SUITE 300A FAIRLAWN, OH 44333 | AFLAC | $29 | — | $29 | 0.06% |
| CHRISTOPHER J BAYER3 Filed as: CHRISTOPHER BAYER | 127 N CHERRY STREET GALESBURG, IL 61401 | AFLAC | $21 | — | $21 | 0.05% |
| TROY ALEXANDER3 | 1532 EAST MARIETTA AVE PEORIA, IL 61616 | AFLAC | $16 | — | $16 | 0.04% |
| GCG FINANCIAL LLC3 Filed as: PAMELA DICKERSON | 120 ARROWHEAD COURT EAST PEORIA, IL 61611 | AFLAC | $15 | — | $15 | 0.03% |
| AMANDA HELMAN3 | 2550 STONEHAVEN DR. SUN PRAIRIE, WI 53590 | AFLAC | $5 | — | $5 | 0.01% |
| BARBIER GROUP INC3 | 414 N ORLEANS ST SUITE 601 CHICAGO, IL 60654 | AFLAC | $3 | — | $3 | 0.01% |
| WAYNE ROWE3 | 1713 COLUMBUS DR PEKIN, IL 61554 | AFLAC | $1 | — | $1 | 0.00% |
| MID ILLINOIS INSURANCE SERVICES INC3 Filed as: MID ILLINOIS INSURANCE | 1524 W GLEN AVE SUITE B PEORIA, IL 61614 | PEKIN LIFE INSURANCE COMPANY | $971 | — | $971 | 6.00% |
| MID ILLINOIS INSURANCE SERVICES INC3 Filed as: MID ILLINOIS INSURANCE SERVICES I | 1524 W GLEN AVE SUITE B PEORIA, IL 61614 | HUMANA | $3K | $19K | $22K | — |
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 | 355 | 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) | 355 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD | 449 | $1.8M |
| Dental | HUMANA | 257 | $0 |
| Life insurance | PEKIN LIFE INSURANCE COMPANY | 311 | $16K |
| Prescription drug | BLUE CROSS BLUE SHIELD | 449 | $1.8M |
| Other | AFLAC | 68 | $46K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 449 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.