| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRIOT GROWTH INSURANCE SERVICES3 | 303 WEST MADISON STREET SUITE 2000 CHICAGO, IL 60606 | BLUECROSS BLUESHIELD OF ILLINOIS | $73K | — | $73K | 4.01% |
| RESOURCE BROKERAGE LLC3 | 1501 WOODFIELD RD #110E SCHAUMBURG, IL 60173 | BLUECROSS BLUESHIELD OF ILLINOIS | $12K | — | $12K | 0.67% |
| JAMES R TAYLOR AGENCY INC3 | 4849 N MILWAUKEE AVE SUITE 506 CHICAGO, IL 60630 | BLUECROSS BLUESHIELD OF ILLINOIS | $62 | $690 | $752 | 0.04% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE | 303 WEST MADISON STREET SUITE 2000 CHICAGO, IL 60606 | GUARDIAN | $5K | $75 | $5K | 11.91% |
| TRUE NETWORK ADVISORS3 | 383 GUNTER AVE GUNTERSVILLE, AL 35976 | GUARDIAN | $227 | — | $227 | 0.59% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 5401 W LAWRENCE AVENUE CHICAGO, IL 60630 | EYEMED VISION CARE | $1K | — | $1K | 11.10% |
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 | 140 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 265 | $1.8M |
| Dental | BLUECROSS BLUESHIELD OF ILLINOIS | 265 | $1.8M |
| Vision | EYEMED VISION CARE | 204 | $11K |
| Life insurance | GUARDIAN | 140 | $39K |
| Short-term disability | GUARDIAN | 140 | $39K |
| Long-term disability | GUARDIAN | 140 | $39K |
| Other(3 contracts, 2 carriers) | GUARDIAN | 140 | $39K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 265 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.