| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CAROL VOGT INSURANCE SERVICES LLC3 | 117 MADISON DRIVE WATERLOO, IL 62298 | BLUE CROSS & BLUE SHIELD OF ILLINOIS | $13K | — | $13K | 8.49% |
| CAROL VOGT INSURANCE SERVICES LLC3 | 117 MADISON DRIVE WATERLOO, IL 62298 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 9.92% |
| DAVID J MCCLELLAN3 Filed as: DAVID G BOYKIN | 4 IVANHOE WOODS COURT KIRKWOOD, MO 63122 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $83 | — | $83 | 0.09% |
| CAROL VOGT INSURANCE SERVICES LLC3 | 117 MADISON DRIVE WATERLOO, IL 62298 | DEARBORN NATIONAL LIFE INSURANCE CO | $1K | — | $1K | 7.69% |
| BAUGHMAN GROUP3 | PO BOX 1115 OFALLON, IL 62868 | DEARBORN NATIONAL LIFE INSURANCE CO | — | $747 | $747 | 4.06% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS & BLUE SHIELD OF IL EIN 36-1236610 NONE | Claims processing Service code 12 | 300 E RANDOLPH STREET CHICAGO, IL 60601 | $136K |
| BARNETT & LEVINE EIN 46-4220046 NONE | Accounting (including auditing) Service code 10 | PO BOX 2677 CARBONDALE, IL 62902 | $10K |
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 | 84 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 40 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 83 | $89K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 83 | $89K |
| Life insurance | DEARBORN NATIONAL LIFE INSURANCE CO | 118 | $18K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS & BLUE SHIELD OF ILLINOIS | 315 | $159K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 315 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.