| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: JMB INSURANCE AGENCY INC | 900 NORTH MICHIGAN AVENUE SUITE 1500 CHICAGO, IL 60611 | BLUECROSS BLUESHIELD OF ILLINOIS | $61K | $1K | $62K | 4.12% |
| ASSUREDPARTNERS3 Filed as: JMB INSURANCE AGENCY INC | 900 NORTH MICHIGAN AVENUE SUITE 1500 CHICAGO, IL 60611 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | $0 | $7K | 10.00% |
| ASSUREDPARTNERS3 Filed as: JMB INSURANCE AGENCY INC | 900 NORTH MICHIGAN AVENUE SUITE 1500 CHICAGO, IL 60611 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 10.00% |
| IMG5 | 2960 NORTH MERIDIAN STREET CHICAGO, IL 60611 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $6 | $6 | 0.02% |
| ASSUREDPARTNERS3 Filed as: JMB INSURANCE AGENCY INC | 900 NORTH MICHIGAN AVENUE SUITE 1500 CHICAGO, IL 60611 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $2K | $0 | $2K | 9.66% |
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 | 199 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 207 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 336 | $1.5M |
| Dental | BLUECROSS BLUESHIELD OF ILLINOIS | 336 | $1.5M |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 319 | $18K |
| Life insurance(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 199 | $97K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 193 | $73K |
| Long-term disability(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 199 | $97K |
| Prescription drug | BLUECROSS BLUESHIELD OF ILLINOIS | 336 | $1.5M |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 199 | $97K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 336 | — |
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.