| 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 | $24K | — | $24K | 7.88% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP, INC. | 5110 NORTH 40TH STREET, SUITE 234 PHOENIX, AZ 85018 | HUMANA INSURANCE COMPANY | $1K | — | $1K | 0.40% |
| ROBERT A BROCK3 Filed as: ROBERT A. BROCK | PO BOX 17 FORSYTH, IL 62535 | AFLAC | $6K | $78 | $6K | 34.98% |
| TARA M JORDAN3 Filed as: TARA M. JORDAN | 800 LAKESHORE DRIVE TUSCOLA, IL 61953 | AFLAC | $1K | $12 | $1K | 8.28% |
| TIMOTHY J REED3 Filed as: TIMOTHY S. INGRAM | 1731 MOUNT ZION ROAD JACKSONVILLE, IL 62650 | AFLAC | $916 | $12 | $928 | 5.40% |
| MARK L RHODES3 Filed as: MARK L. RHODES AND OTHER AGENTS | 225 EAST CRESTWOOD STREET MORTON, IL 61550 | AFLAC | $74 | $0 | $74 | 0.43% |
| JUNE D BROCK3 Filed as: JUNE D. BROCK | 306 SOUTH SMITH STREET FORSYTH, IL 62535 | AFLAC | $46 | $0 | $46 | 0.27% |
| DAVID M CRUMLEY3 Filed as: DAVID M. CRUMLEY | 132 SEDONA WOODS TRAIL NOLENSVILLE, TN 37135 | AFLAC | $19 | $0 | $19 | 0.11% |
| JUDUTH HAEFLINGER3 | 1275 SAXONY CIRCLE, UNIT 3205 PUNTA GORDA, FL 33983 | AFLAC | $19 | $0 | $19 | 0.11% |
| USI INSURANCE SERVICES LLC3 | 312 ELM STREET, SUITE 2400 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 | 214 | 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) | 214 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH ALLIANCE MEDICAL PLANS | 504 | $2.2M |
| Dental | HUMANA INSURANCE COMPANY | 214 | $306K |
| Vision | HUMANA INSURANCE COMPANY | 214 | $306K |
| Life insurance | HUMANA INSURANCE COMPANY | 214 | $306K |
| Long-term disability | HUMANA INSURANCE COMPANY | 214 | $306K |
| Prescription drug | HEALTH ALLIANCE MEDICAL PLANS | 504 | $2.2M |
| Other(3 contracts, 3 carriers) | HUMANA INSURANCE COMPANY | 214 | $324K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 504 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.