| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $0 | $8K | 12.74% |
| ASSURANCE AGENCY LTD3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 13.70% |
| KME INSURANCE BROKERAGE, INC.3 Filed as: KME INSURANCE BROKERAGE INC | 125 S WACKER DR., STE. 300 CHICAGO, IL 60606 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 7.46% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: ASSURANCE, A MARSH & MCLENNAN AGCY | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | EYEMED VISION CARE | $1K | $0 | $1K | 10.99% |
| MARSH & MCLENNAN AGENCY LLC3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $56 | $1K | 12.87% |
| HOWARD HOROWITZ3 Filed as: HOWARD J HOROWITZ | 2610 ALCOTT STREET CARMEL, IN 46032 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $386 | $114 | $500 | 4.62% |
| YESENIA A SANCHEZ3 Filed as: YESENIA A HERNANDEZ | 6715 S KEELER AVE CHICAGO, IL 60629 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $135 | $31 | $166 | 1.54% |
| JANTELLE LAVONNE BONNER3 | 99 N POST OAK LANE, APT 5302 HOUSTON, TX 77024 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $126 | $0 | $126 | 1.17% |
| ELAISIUS BONNER3 | 974 ROSEFIELD LANE AURORA, IL 60504 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $83 | $0 | $83 | 0.77% |
| VALUE ADDED SOLUTIONS3 | 1161 HERITAGE CT SUN PRAIRIE, WI 53590 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $16 | $16 | $32 | 0.30% |
| DEBRA POCZATKO3 Filed as: DEBRA RENEE BARCH | 14466 S ELIZABETH LANE HOMER GLEN, IL 60491 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $27 | $4 | $31 | 0.29% |
| NORMAC SOLUTIONS INC3 | 449 HOPKINS ROAD TOWNVILLE, SC 29689 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $23 | $0 | $23 | 0.21% |
| HENRY J SAMAAN3 Filed as: HENRY JACOB SAMAAN | 19W152 21ST PLACE LOMBARD, IL 60148 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $13 | $4 | $17 | 0.16% |
| CLARICE R MIMS3 | 133 HILLCREST DRIVE MARLBORO, NY 12542 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $14 | $1 | $15 | 0.14% |
| GERALD A GREENEN3 | 472 ROUTE 47 STE F-102 SUGAR GROVE, IL 60554 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8 | $4 | $12 | 0.11% |
| MICHAEL BLOCK3 | 41 ARUM CT ST AUGUSTINE, FL 32095 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8 | $0 | $8 | 0.07% |
| DAVID J MCCLELLAN3 | 118 ROYAL HORSE WAY REINHOLDS, PA 17569 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | $6 | $8 | 0.07% |
| TEKAYLA WORKS3 | 115 VILLAGE BEND DRIVE ALEXANDER, AR 72002 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6 | $0 | $6 | 0.06% |
| REBECCA STERNBERG3 | 374 MILFORD RD DEERFIELD, IL 60015 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6 | $0 | $6 | 0.06% |
| PATRICIA A DUNCAN3 | 520 WHEATFIELD RD. FRANKLIN, NC 28734 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.02% |
| ASSURANCE AGENCY LTD3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 27.06% |
| KME INSURANCE BROKERAGE, INC.3 Filed as: KME INS BROKERAGE INC | 125 S WACKER DR, STE 300 CHICAGO, IL 60606 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 21.00% |
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 | 135 | 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) | 135 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE | 166 | $12K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 106 | $59K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 106 | $59K |
| Long-term disability(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 106 | $85K |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 165 | $73K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 166 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.