| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA | WINE SERGI AND CO. LLC 1000 E WARRENVILLE RD., STE.101 NAPERVILLE, IL 60563 | BLUECROSS BLUESHIELD OF ILLINOIS | $79K | $1K | $80K | 3.49% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA | WINE SERGI AND CO. LLC 1000 E WARRENVILLE RD., STE. 101 NAPERVILLE, IL 60563 | DELTA DENTAL OF ILLINOIS | $6K | — | $6K | 4.37% |
| ACRISURE LLC2 Filed as: ACRISURE LLC DBA | WINE SERGI AND CO. LLC 1000 E WARRENVILLE RD., STE. 101 NAPERVILLE, IL 60563 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 5.12% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA | WINE SERGI AND CO. LLC 1000 E WARRENVILLE RD., STE. 101 NAPERVILLE, IL 60563 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 15.00% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA | WINE SERGI AND CO. LLC 1000 E WARRENVILLE RD., STE. 101 NAPERVILLE, IL 60563 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $170 | — | $170 | 3.66% |
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 | 168 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 174 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 390 | $2.3M |
| Dental | DELTA DENTAL OF ILLINOIS | 168 | $132K |
| Vision | VISION SERVICE PLAN | 162 | $16K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 198 | $120K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 14 | $5K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 42 | $46K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 198 | $120K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 390 | — |
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.