| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | UNITEDHEALTHCARE INSURANCE COMPANY | $61K | — | $61K | 3.67% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 45263 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | $960 | $10K | 11.03% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: INSENTIAL INC | 206 S JEFFERSON ST STE 200 CHICAGO, IL 60661 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | — | $5K | 5.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: INSENTIAL INC DBA SOURCE 1 BENEFITS | 206 S JEFFERSON ST STE 200 CHICAGO, IL 60661 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 2.61% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS INC | 55 SHUMAN BLVD STE 550 NAPERVILLE, IL 60563 | METROPOLITAN LIFE INSURANCE COMPANY | $773 | $26 | $799 | 0.86% |
| NORTHERN INSURANCE GROUOP LTD3 | 114 W NORTH ST MORRIS, IL 60450 | VISION SERVICE PLAN | $810 | — | $810 | 6.98% |
| NICHOLAS DEAN POTTHOFF3 | 110 E MAIN ST STE 220 OTTAWA, IL 61350 | NORTHWESTERN MUTUAL | $170 | $39 | $209 | 11.11% |
| CHET DOUGLAS BANDY3 | 1600 HUNT DR NORMAL, IL 61761 | NORTHWESTERN MUTUAL | $28 | $7 | $35 | 1.86% |
| MCCLURE FNCL GROUP INC3 | 301 N NEIL ST STE 501 CHAMPAIGN, IL 61820 | NORTHWESTERN MUTUAL | $25 | $2 | $27 | 1.44% |
| NICHOLAS DEAN POTTHOFF3 | 110 E MAIL ST STE 220 OTTAWA, IL 61350 | NORTHWESTERN MUTUAL | $119 | $28 | $147 | 16.59% |
| CHET DOUGLAS BANDY3 | 1600 HUNT DR NORMAL, IL 61761 | NORTHWESTERN MUTUAL | $20 | $5 | $25 | 2.82% |
| MCCLURE FNCL GROUP INC3 Filed as: MCCLURE FINANCIAL GROUP INC | 301 N NEIL ST STE 501 CHAMPAIGN, IL 61820 | NORTHWESTERN MUTUAL | $18 | $1 | $19 | 2.14% |
| HORIZON INSURANCE & ASSOC3 | PO BOX 1561 BLOOMINGTON, IL 61702 | HUMANA INSURANCE COMPANY | $91 | — | $91 | 14.94% |
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 | 131 | 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) | 131 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 282 | $1.7M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 488 | $93K |
| Vision | VISION SERVICE PLAN | 94 | $12K |
| Life insurance | HUMANA INSURANCE COMPANY | 124 | $609 |
| Short-term disability | NORTHWESTERN MUTUAL | 0 | $2K |
| Long-term disability | NORTHWESTERN MUTUAL | 0 | $886 |
| Other | HUMANA INSURANCE COMPANY | 124 | $609 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 488 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.