| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E GOLF RD SCHAUMBURG, IL 60173 | AETNA | $12K | — | $12K | 11.24% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E GOLF RD SCHAUMBURG, IL 60173 | COMPANION LIFE INS CO | $9K | — | $9K | 10.00% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY, LTD | 1750 EAST GOLF ROAD SCHAUMBURG, IL 60173 | COMPANION LIFE INSURANCE COMPANY | $4K | — | $4K | 5.42% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 Filed as: BCBS OF SOUTH CAROLINA | I. 20 AT ALPINE ROAD COLUMBIA, SC 29219 | COMPANION LIFE INSURANCE COMPANY | $2K | — | $2K | 2.71% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E GOLF RD SCHAUMBURG, IL 60173 | ALLSTATE WORKPLACE | $2K | — | $2K | 4.89% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM AND BUTLER INS SVCS | PO BOX 28 DUBUQUE, IA 52004 | ALLSTATE WORKPLACE | $2K | — | $2K | 4.89% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E GOLF RD SCHAUMBURG, IL 60173 | VISION SERVICE PLAN | $1K | — | $1K | 5.48% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E GOLF RD SCHAUMBURG, IL 60173 | AMERICAN HERITAGE LIFE INSURANCE CO | $5K | — | $5K | 37.62% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM AND BUTLER INS SVCS | PO BOX 28 DUBUQUE, IA 52004 | AMERICAN HERITAGE LIFE INSURANCE CO | $5K | — | $5K | 35.09% |
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 | 1,504 | 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) | 1,504 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | COMPANION LIFE INS CO | 367 | $166K |
| Vision(2 contracts, 2 carriers) | COMPANION LIFE INS CO | 367 | $112K |
| Life insurance(2 contracts, 2 carriers) | AETNA | 595 | $146K |
| Short-term disability(2 contracts, 2 carriers) | AETNA | 595 | $146K |
| Long-term disability | AETNA | 287 | $110K |
| Stop-loss / reinsurancereinsurance | NATIONWIDE LIFE INSURANCE CO | 1,504 | $749K |
| Other(2 contracts, 2 carriers) | AETNA | 287 | $123K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,504 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.