| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT A BROCK3 Filed as: ROBERT A. BROCK | PO BOX 17 FORSYTHE, IL 62535 | HUMANA INSURANCE COMPANY | $6K | $0 | $6K | 3.24% |
| JARED JASON3 | 310 SOUTH FIRST STREET, SUITE 102 CHAMPAIGN, IL 61820 | KANSAS CITY LIFE INSURANCE | $13K | $0 | $13K | 10.24% |
| ROBERT A BROCK3 Filed as: ROBERT A. BROCK | 306 SOUTH SMITH FORSYTHE, IL 62535 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 14.91% |
| KEITH MCELYEA3 Filed as: KEITH J. MCELYEA | 512 SPITLER PARK PLAZA MOUNT ZION, IL 65249 | CONTINENTAL AMERICAN INSURANCE COMPANY | $399 | $0 | $399 | 3.84% |
| DEVIN M PEGRAM3 Filed as: DEVIN M. PEGRAM | 1450 LENHART ROAD SPRINGFIELD, IL 62711 | CONTINENTAL AMERICAN INSURANCE COMPANY | $174 | $0 | $174 | 1.67% |
| GREORGE P. OWENS3 | 653 ANTLER DRIVE MOUNT ZION, IL 62549 | CONTINENTAL AMERICAN INSURANCE COMPANY | $120 | $0 | $120 | 1.15% |
| SHARYL K BATHE3 Filed as: SHARYL K. BATHE | 1816 BROADWAY AVENUE MATTOON, IL 61938 | CONTINENTAL AMERICAN INSURANCE COMPANY | $88 | $0 | $88 | 0.85% |
| MJ INSURANCE3 Filed as: TERRY J. SILVERS AND VARIOUS AGENTS | 120 WEST ALLEN STREET HENDERSONVILLE, NC 28792 | CONTINENTAL AMERICAN INSURANCE COMPANY | $83 | $0 | $83 | 0.80% |
| JASON HOFFARD3 Filed as: JASON T. HOFFARD | 16485 BANISTER ROAD SESSER, IL 62884 | CONTINENTAL AMERICAN INSURANCE COMPANY | $32 | $0 | $32 | 0.31% |
| MJ INSURANCE3 Filed as: DAVID CRUMLEY AND VARIOUS AGENTS | 132 SEDONA WOODS TRAIL NOLENSVILLE, TN 37135 | AFLAC | $149 | $0 | $149 | 3.28% |
| ROBERT A BROCK3 Filed as: ROBERT A. BROCK | PO BOX 17 FORSYTHE, IL 62535 | AFLAC | $100 | $0 | $100 | 2.20% |
| JUNE D BROCK3 Filed as: JUNE D. BROCK | 306 SOUTH SMITH STREET FORSYTHE, IL 62535 | AFLAC | $97 | $0 | $97 | 2.13% |
| MARK L RHODES3 Filed as: MARK L. RHODES | 1513 WEST COLUMBIA TERRACE APARTMENT 2 PEORIA, IL 61606 | AFLAC | $50 | $0 | $50 | 1.10% |
| STEPHEN L BLUST3 Filed as: STEPHEN L. BUST | 1114 EAST OAKLAND AVENUE BLOOMINGTON, IL 61701 | AFLAC | $38 | $0 | $38 | 0.84% |
| TERRANCE M BRENNAN3 Filed as: TERRANCE M. BRENNAN | 605 NORTH PARK AVENUE CHATHAM, IL 62629 | AFLAC | $35 | $0 | $35 | 0.77% |
| GEORGE P OWENS3 Filed as: GEORGE P. OWENS | 653 NORTH ANTLER DRIVE MOUNT ZION, IL 62549 | AFLAC | $30 | $0 | $30 | 0.66% |
| 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 | 244 | 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) | 244 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH ALLIANCE MEDICAL PLANS | 413 | $2.4M |
| Dental | HUMANA INSURANCE COMPANY | 171 | $190K |
| Vision | HUMANA INSURANCE COMPANY | 171 | $190K |
| Life insurance | KANSAS CITY LIFE INSURANCE | 244 | $128K |
| Long-term disability | KANSAS CITY LIFE INSURANCE | 244 | $128K |
| Prescription drug | HEALTH ALLIANCE MEDICAL PLANS | 413 | $2.4M |
| Other(4 contracts, 4 carriers) | KANSAS CITY LIFE INSURANCE | 244 | $144K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 413 | — |
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.
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.