| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERVICE | P.O. BOX 632886 CINCINNATI, OH 45263 | BLUECROSS BLUESHIELD OF ILLINOIS | $48K | $927 | $49K | 3.32% |
| ASSUREDPARTNERS3 Filed as: DIMOND BROS. INSURANCE, LLC | P.O. BOX 1090 PARIS, IL 61944 | BLUECROSS BLUESHIELD OF ILLINOIS | $9K | — | $9K | 0.64% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERVICE | P.O. BOX 632886 CINCINNATI, OH 45263 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $403 | $2K | 2.16% |
| ASSUREDPARTNERS3 Filed as: DIMOND BROS. INSURANCE, LLC | P.O. BOX 1090 PARIS, IL 61944 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 1.65% |
| ASSUREDPARTNERS3 Filed as: DIMOND BROS. INSURANCE, LLC | P.O. BOX 1090 PARIS, IL 61944 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 3.34% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 4365 SOUTHWEST FWY, STE 750 HOUSTON, TX 77027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 1.91% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERVICE | P.O. BOX 632886 CINCINNATI, OH 45263 | VISION SERVICE PLAN | $478 | — | $478 | 3.53% |
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 | 147 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 147 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 213 | $1.5M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 279 | $104K |
| Vision | VISION SERVICE PLAN | 124 | $14K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 145 | $83K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 145 | $83K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 145 | $83K |
| Prescription drug | BLUECROSS BLUESHIELD OF ILLINOIS | 213 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 279 | — |
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.