| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROSS & YERGER INSURANCE INC Filed as: JD ROSS INSURANCE | — | BLUECROSS BLUESHIELD OF ILLINOIS | $57K | — | $57K | 3.59% |
| GROUP MARKETING SERVICES INC Filed as: GROUP MARKETING SERVICES | — | BLUECROSS BLUESHIELD OF ILLINOIS | $920 | — | $920 | 0.06% |
| DERJENN ENTERPRISES DBA JD ROSS & A3 Filed as: DERJENN ENTERPRISES DBA J D ROSS & | 9 KENDALL AVE BARRY, IL 623122219 | METROPOLITAN LIFE INSURANCE COMPANY | $17K | — | $17K | 6.72% |
| J.D. ROSS AND ASSOCIATES, INC. Filed as: J.D. ROSS AND ASSOCIATES INC | 9 KENDALL AVE BARRY, IL 623122219 | VISION SERVICE PLAN | $1K | — | $1K | 5.23% |
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 | 183 | 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. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 184 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 307 | $1.6M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 434 | $257K |
| Vision | VISION SERVICE PLAN | 150 | $20K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 434 | $257K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 434 | $257K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 434 | $257K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 434 | $257K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 434 | — |
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.