| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY, LTD | 1750 EAST GOLF ROAD SCHAUMBURG, IL 60173 | AETNA LIFE INSURANCE COMPANY | — | $6K | $6K | 0.41% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY, LTD | 1750 EAST GOLF ROAD CHICAGO, IL 60173 | DELTA DENTAL | $4K | — | $4K | 3.00% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E GOLF RD SCHAUMBURG, IL 60173 | PRUDENTIAL INSURANCE CO | $11K | — | $11K | 10.69% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PRUDENTIAL INSURANCE CO | $1K | — | $1K | 1.10% |
| AXA ASSISTANCE, USA5 Filed as: AXA ASSISTANCE USA | 122 SOUTH MICHIGAN AVE, STE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE CO | — | $37 | $37 | 0.04% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY, LTD | 1750 E GOLF ROAD CHICAGO, IL 60173 | VISION SERVICE PLAN | $1K | — | $1K | 4.22% |
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 | 113 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 115 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 289 | $1.4M |
| Dental | DELTA DENTAL | 106 | $133K |
| Vision | VISION SERVICE PLAN | 90 | $25K |
| Life insurance | PRUDENTIAL INSURANCE CO | 115 | $104K |
| Short-term disability | PRUDENTIAL INSURANCE CO | 115 | $104K |
| Long-term disability | PRUDENTIAL INSURANCE CO | 115 | $104K |
| Other | PRUDENTIAL INSURANCE CO | 115 | $104K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 289 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.