| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT A BROCK3 | PO BOX 17 FORSYTH, IL 625350017 | HUMANA INSURANCE COMPANY | $5K | $2K | $7K | 5.62% |
| JASON JARED3 | 2107 SOUTH NEIL STRE CHAMPAIGN, IL 61853 | KANSAS CITY LIFE INSURANCE COMPANY | $6K | — | $6K | 8.37% |
| DOUGLAS L LAZ3 | 2107 S NEIL ST CHAMPAIGN, IL 61820 | KANSAS CITY LIFE INSURANCE COMPANY | $3K | — | $3K | 3.41% |
| ROBERT A BROCK3 | 306 SOUTH SMITH FORSYTH, IL 62535 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 8.42% |
| GEORGE P OWENS3 | 653 ANTLER DRIVE MT ZION, IL 62549 | CONTINENTAL AMERICAN INSURANCE COMPANY | $247 | — | $247 | 2.00% |
| SHARYL K BATHE3 | 1816 BROADWAY AVE MATTOON, IL 61938 | CONTINENTAL AMERICAN INSURANCE COMPANY | $219 | — | $219 | 1.78% |
| KEITH MCELYEA3 Filed as: KEITH J MCELYEA | 512 SPITLER PARK PLZ MT ZION, IL 62549 | CONTINENTAL AMERICAN INSURANCE COMPANY | $195 | — | $195 | 1.58% |
| JASON HOFFARD3 Filed as: JASON T HOFFARD | 16485 BANISTER RD SESSER, IL 62884 | CONTINENTAL AMERICAN INSURANCE COMPANY | $65 | — | $65 | 0.53% |
| TERRY J SILVERS3 | 120 W ALLEN STREET HENDERSONVILLE, NC 28792 | CONTINENTAL AMERICAN INSURANCE COMPANY | $59 | — | $59 | 0.48% |
| TAMMY KILGORE3 Filed as: TAMMY L KILGORE | 210 N PLUM STREET PONTIAC, IL 61764 | CONTINENTAL AMERICAN INSURANCE COMPANY | $17 | — | $17 | 0.14% |
| TRAVIS COCKBURN3 | 402 N MAIN STREET BENTON, IL 62812 | CONTINENTAL AMERICAN INSURANCE COMPANY | $16 | — | $16 | 0.13% |
| TRAVIS COCKBURN3 | 402 N MAIN STREET BENTON, IL 62812 | CONTINENTAL AMERICAN INSURANCE COMPANY | $12 | — | $12 | 0.10% |
| JASON HOFFARD3 Filed as: JASON T HOFFARD | 16485 BANISTER RD SESSER, IL 62884 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5 | — | $5 | 0.04% |
| MARTHA MONCKTON3 Filed as: MARTHA S MONCKTON | 2411 E GRANDVIEW AVE PEORIA, IL 61614 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5 | — | $5 | 0.04% |
| TARA JORDAN3 | 800 LAKESHORE DR TUSCOLA, IL 61953 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5 | — | $5 | 0.04% |
| ROBERT A BROCK3 | PO BOX 17 FORSYTH, IL 62535 | AFLAC | $235 | — | $235 | 2.64% |
| JUNE D BROCK3 | 306 S SMITH ST FORSYTH, IL 62535 | AFLAC | $180 | — | $180 | 2.03% |
| DAVID M CRUMLEY3 | 5111 MARYLAND WAY STE 210 BRENTWOOD, TN 37027 | AFLAC | $102 | — | $102 | 1.15% |
| TERRANCE M BRENNAN3 | 2207 BENJAMIN LN BLOOMINGTON, IL 61701 | AFLAC | $85 | — | $85 | 0.96% |
| STEPHEN L BLUST3 | 1114 E OAKLAND AVE BOX 1561 BLOOMINGTON, IL 61701 | AFLAC | $80 | — | $80 | 0.90% |
| MARK L RHODES3 | 133A SOUTH MAIN ST MORTON, IL 61550 | AFLAC | $77 | — | $77 | 0.87% |
| GEORGE P OWENS3 | 653 N ANTLER DR MT ZION, IL 62549 | AFLAC | $42 | — | $42 | 0.47% |
| HANA M MUELLER3 | PO BOX 283 STANFORD, IL 61774 | AFLAC | $38 | — | $38 | 0.43% |
| CHRISTINE L BREWSTER3 | 1312 FARLEY LN CHAMPAIGN, IL 61822 | AFLAC | $34 | — | $34 | 0.38% |
| GARY W WARE JR3 | 2306 VALLEYBROK DR CHAMPAIGN, IL 61822 | AFLAC | $29 | — | $29 | 0.33% |
| JUDITH HAEFLINGER3 | 1275 SAXONY CIR UNIT 3205 PUNTA GORDA, FL 33983 | AFLAC | $21 | — | $21 | 0.24% |
| HEATHER HEIL3 | 53 BROOKSIDE DR APT D CLIFTON, NJ 07012 | AFLAC | $12 | — | $12 | 0.14% |
| ANDY BILISOLY3 | 719 E IREDELL AVE MOORESVILLE, NC 28115 | AFLAC | $11 | — | $11 | 0.12% |
| TERRY J SILVERS3 | 100 GREENLEAF DR FLAT ROCK, NC 28731 | AFLAC | $11 | — | $11 | 0.12% |
| ROY TRIMBLE3 | 810 S JOHANSON RD APT D PEORIA, IL 61607 | AFLAC | $10 | — | $10 | 0.11% |
| CHRISTOPHER A SKEETERS3 | 808 N BRUNS LN SPRINGFIELD, IL 62702 | AFLAC | $9 | — | $9 | 0.10% |
| ELIZABETH BILISOLY3 | 1405 WRAY RD STONEVILLE, NC 27048 | AFLAC | $8 | — | $8 | 0.09% |
| BRIAN R KIMMEL3 | 309 BRAESWICK DR LAKE ST LOUIS, MO 63367 | AFLAC | $6 | — | $6 | 0.07% |
| GREGORY J SHARP3 | 702 E 5TH ST COAL VALLEY, IL 61240 | AFLAC | $5 | — | $5 | 0.06% |
| TYE ELLIOTT3 | 1300 N INDEPENDENCE CT GERMANTOWN HILLS, IL 61548 | AFLAC | $5 | — | $5 | 0.06% |
| CHRISTIE MARZARI3 | 1932 WYNNTON RD COLUMBUS, GA 31999 | AFLAC | $4 | — | $4 | 0.05% |
| ELIZABETH M GASPAROVIC3 | 1531 W RUE JAMES PL PALATINE, IL 60067 | AFLAC | $3 | — | $3 | 0.03% |
| LORI WARE3 | 2306 VALLEYBROOK DR CHAMPAIGN, IA 61822 | AFLAC | $3 | — | $3 | 0.03% |
| TRAVIS COCKBURN3 Filed as: TRAVIS J COCKBURN | 402 N MAIN ST BENTON, IL 62812 | AFLAC | $1 | — | $1 | 0.01% |
| JOSEPH L LEDOUX3 | 2411 CARTER AVE NASHVILLE, TN 37206 | AFLAC | $1 | — | $1 | 0.01% |
| KYLE J HORN3 | 2119 W GERALD DR PEORIA, IL 61615 | AFLAC | $1 | — | $1 | 0.01% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | PO BOX 4016 CHAMPAIGN, IL 61824 | HARTFORD LIFE AND ACCIDENT | $113 | — | $113 | 15.07% |
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 | 211 | 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) | 211 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH ALLIANCE MEDICAL PLANS | 393 | $1.7M |
| Dental | HUMANA INSURANCE COMPANY | 173 | $127K |
| Vision | HUMANA INSURANCE COMPANY | 173 | $127K |
| Life insurance | KANSAS CITY LIFE INSURANCE COMPANY | 170 | $77K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 40 | $750 |
| Long-term disability | KANSAS CITY LIFE INSURANCE COMPANY | 170 | $77K |
| Prescription drug | HEALTH ALLIANCE MEDICAL PLANS | 393 | $1.7M |
| Other(3 contracts, 3 carriers) | KANSAS CITY LIFE INSURANCE COMPANY | 170 | $98K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 393 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.