| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VISTA NATIONAL INSURANCE GROUP INC3 | — | BLUE CROSS BLUE SHIELD OF ILLINOIS | $98K | $2K | $100K | 3.50% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF ILLNOIS INC | — | BLUE CROSS BLUE SHIELD OF ILLINOIS | — | $6K | $6K | 0.20% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF ILLINOIS INC | 263 SHUMAN BOULEVARD SUITE 110 NAPERVILLE, IL 60563 | DEARBORN LIFE INSURANCE COMPANY | $2K | $10K | $11K | 5.52% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF ILLINOIS INC | 1301 WEST 22ND STREET SUITE 600 OAK BROOK, IL 60523 | DEARBORN LIFE INSURANCE COMPANY | $9K | — | $9K | 4.55% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF ILLINOIS, INC | 1301 WEST 22ND STREET SUITE 600 OAK BROOK, IL 60523 | VISION SERVICE PLAN | $1K | — | $1K | 5.61% |
| VISTA NATIONAL INSURANCE GROUP INC3 Filed as: VISTA NATIONAL INSURANCE GROUP | 1301 WEST 22ND STREET SUITE 600 OAK BROOK, IL 60523 | VISION SERVICE PLAN | $53 | — | $53 | 0.23% |
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 | 319 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 323 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 415 | $2.9M |
| Dental | BLUE CROSS BLUE SHIELD OF ILLINOIS | 415 | $2.9M |
| Vision | VISION SERVICE PLAN | 177 | $23K |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 319 | $206K |
| Short-term disability | DEARBORN LIFE INSURANCE COMPANY | 319 | $206K |
| Long-term disability | DEARBORN LIFE INSURANCE COMPANY | 319 | $206K |
| Other(4 contracts, 4 carriers) | DEARBORN LIFE INSURANCE COMPANY | 1,041 | $228K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,041 | — |
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.