| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT A BROCK3 Filed as: ROBERT A. BROCK | PO BOX 17 FORSYTH, IL 62535 | HUMANA INSURANCE COMPANY | $5K | $0 | $5K | 4.09% |
| JARED JASON3 | 310 SOUTH FIRST STREET, SUITE 102 CHAMPAIGN, IL 61820 | KANSAS CITY LIFE INSURANCE | $12K | $0 | $12K | 9.77% |
| ROBERT A BROCK3 | 306 SOUTH SMITH FORSYTH, IL 62535 | CONTINENTAL AMERICAN INSURANCE COMPANY | $270 | $0 | $270 | 3.22% |
| KEITH MCELYEA3 Filed as: KEITH J MCELYEA | 512 SPITLER PARK PLAZA MT ZION, IL 62549 | CONTINENTAL AMERICAN INSURANCE COMPANY | $87 | $0 | $87 | 1.04% |
| GEORGE P OWENS3 | 653 ANTLER DRIVE MT ZION, IL 62549 | CONTINENTAL AMERICAN INSURANCE COMPANY | $54 | $0 | $54 | 0.64% |
| SHARYL K BATHE3 Filed as: SHARYL K JUNEAU | 1816 BROADWAY AVENUE MATTOON, IL 61938 | CONTINENTAL AMERICAN INSURANCE COMPANY | $39 | $0 | $39 | 0.46% |
| MJ INSURANCE3 Filed as: TERRY J SILVERS AND VARIOUS AGENTS | 120 WEST ALLEN STREET HENDERSONVILLE, NC 28792 | CONTINENTAL AMERICAN INSURANCE COMPANY | $39 | $0 | $39 | 0.46% |
| DEVIN M PEGRAM3 | 1450 LENHART ROAD SPRINGFIELD, IL 62711 | CONTINENTAL AMERICAN INSURANCE COMPANY | $20 | $0 | $20 | 0.24% |
| JASON HOFFARD3 Filed as: JASON T HOFFARD | 16485 BANISTER ROAD SESSER, IL 62884 | CONTINENTAL AMERICAN INSURANCE COMPANY | $14 | $0 | $14 | 0.17% |
| MJ INSURANCE3 Filed as: GEORGE P OWENS AND VARIOUS AGENTS | 653 NORTH ANTLER DRIVE MT ZION, IL 62549 | AFLAC | $174 | $0 | $174 | 3.27% |
| ROBERT A BROCK3 | PO BOX 17 FORSYTH, IL 62535 | AFLAC | $144 | $0 | $144 | 2.71% |
| JUNE D BROCK3 | 306 SOUTH SMITH STREET FORSYTH, IL 62535 | AFLAC | $106 | $0 | $106 | 1.99% |
| MARK L RHODES3 | 1513 WEST COLUMBIA TERRACE APARTMENT 2 PEORIA, IL 61606 | AFLAC | $50 | $0 | $50 | 0.94% |
| DAVID M CRUMLEY3 | 5111 MARYLAND WAY, SUITE 210 BRENTWOOD, TN 37027 | AFLAC | $45 | $0 | $45 | 0.85% |
| TERRANCE M BRENNAN3 | 605 NORTH PARK AVENUE CHATHAM, IL 62629 | AFLAC | $40 | $0 | $40 | 0.75% |
| STEPHEN L BLUST3 | 1114 EAST OAKLAND AVENUE, BOX 1561 BLOOMINGTON, IL 61701 | AFLAC | $39 | $0 | $39 | 0.73% |
| USI INSURANCE SERVICES LLC3 | 312 ELM STREET , 24TH FLOOR CINCINNATI, OH 45202 | HARTFORD LIFE AND ACCIDENT | $113 | $38 | $151 | 20.13% |
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 | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 194 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH ALLIANCE MEDICAL PLAN | 422 | $1.8M |
| Dental | HUMANA INSURANCE COMPANY | 174 | $134K |
| Vision | HUMANA INSURANCE COMPANY | 174 | $134K |
| Life insurance | KANSAS CITY LIFE INSURANCE | 194 | $119K |
| Long-term disability | KANSAS CITY LIFE INSURANCE | 194 | $119K |
| Prescription drug | HEALTH ALLIANCE MEDICAL PLAN | 422 | $1.8M |
| Other(4 contracts, 4 carriers) | KANSAS CITY LIFE INSURANCE | 194 | $133K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 422 | — |
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."
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.