| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | STARMOUNT LIFE INSURANCE COMPANY | $4K | $1K | $5K | 6.68% |
| ASSURANCE AGENCY LTD3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $192 | $3K | 10.72% |
| ASSURANCE AGENCY LTD3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $182 | $3K | 10.71% |
| ASSURANCE AGENCY LTD3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | EYEMED | $2K | $0 | $2K | 10.00% |
| ASSURANCE AGENCY LTD3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $958 | $85 | $1K | 10.89% |
| HOWARD HOROWITZ3 Filed as: HOWARD J HOROWITZ | 2610 ALCOTT STREET CARMEL, IN 46032 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $229 | $79 | $308 | 13.09% |
| ASSURANCE AGENCY LTD3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $236 | $0 | $236 | 10.03% |
| NORMAC SOLUTIONS INC3 Filed as: NORMAC SOLUTIONS INC. | 451 HOPKINS ROAD TOWNVILLE, SC 29689 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $108 | $110 | $218 | 9.26% |
| ELAISIUS BONNER3 | 974 ROSEFIELD LANE AURORA, IL 60504 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $87 | $69 | $156 | 6.63% |
| JANTELLE LAVONNE BONNER3 | 974 ROSEFIELD LANE AURORA, IN 60504 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $66 | $60 | $126 | 5.35% |
| VINCENT J ROWAN3 | 4447 EAST THOMPSON STREET PHILADELPHIA, PA 19137 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $77 | $3 | $80 | 3.40% |
| DAVID J MCCLELLAN3 | 118 ROYAL HORSE WAY REINHOLDS, PA 17569 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $12 | $29 | $41 | 1.74% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $37 | $4 | $41 | 1.74% |
| BRANDON MARCELLO CENTO3 | 17362 DOVEHOUSE LANE WESTFIELD, IN 46074 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8 | $12 | $20 | 0.85% |
| ASSURANCE AGENCY LTD3 | 20 N. MARTINGALE RD., STE. 100 SCHAUMBURG, IL 60173 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $350 | $19 | $369 | 15.84% |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | 195 | $1.3M | |
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 84 | $71K |
| Vision | EYEMED | 156 | $15K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 101 | $27K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 36 | $26K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 185 | $10K |
| Prescription drug | 195 | $1.3M | |
| Other(3 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 101 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 195 | — |
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.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.