| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | BLUECROSS BLUESHIELD OF ILLINOIS | $28K | — | $28K | 6.58% |
| LINDEN GROUP HEALTH SERVICES INC.3 | 2800 RIVER ROAD SUITE 310 DES PLAINES, IL 60018 | BLUECROSS BLUESHIELD OF ILLINOIS | -$10K | $2K | -$9K | -2.02% |
| THE HEALTH SOLUTIONS INSURANCE AGCY3 | 184 WORCESTER PROVIDENCE TPK SUTTON, MA 015902902 | TUFTS ASSOCIATED HEALTH MAINTENANCE ORG. INC. | $10K | $1K | $11K | 2.99% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: CREATIVE RISK MANAGEMENT | PO BOX 650 NYACK, NY 10960 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $13K | — | $13K | 9.14% |
| HJM GROUP, INC.3 | 207 BRIARWOOD DRIVE SOMERS, NY 10589 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $3K | — | $3K | 2.08% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | $5K | $12K | 14.69% |
| MARK METTILLE3 Filed as: MARK C PIETSCH | 10816 CRYSTAL SPRINGS LANE ORLAND PARK, IL 60467 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $63 | — | $63 | 0.08% |
| LANNY D. LEVIN AGENCY, INC.3 Filed as: LANNY D LEVIN AGENCY, INC. | 1751 LAKE COOK ROAD SUITE 350 DEERFIELD, IL 60015 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $6 | — | $6 | 0.01% |
| HEALTH SOLUTIONS INC.3 | PO BOX 183698 SHELBY TOWNSHIP, MI 48318 | KC LIFE | $3K | — | $3K | 7.65% |
| HEALTH SOLUTIONS INS AGCY LLC3 | 184 WORCESTER PROVIDENCE TURNPIKE SUTTON, MA 015902902 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $2K | $107 | $2K | 6.41% |
| TAYLOR & TAYLOR ASSOCIATES3 Filed as: TAYLOR & TAYLOR ASSOCIATES, INC. | 271 MADISON AVENUE 5TH FLOOR NEW YORK, NY 10016 | NATIONAL UNION FIRE INS CO OF PITTSBURGH | $334 | — | $334 | 15.02% |
| THE HEALTH SOLUTIONS INSURANCE AGCY3 Filed as: HEALTH SOLUTIONS INSURANCE AGNCY | 184 WORCESTER PROVIDENCE TPK SUTTON, MA 015902902 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $506 | — | $506 | 24.59% |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS INC. | ONE ENTERPRISE DR SUITE 210 SHELTON, CT 06484 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $103 | $103 | 5.00% |
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 | 1,025 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,037 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 115 | $1.8M |
| Dental(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 94 | $154K |
| Vision(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 386 | $142K |
| Life insurance(3 contracts, 3 carriers) | AMERICAN GENERAL LIFE INSURANCE COMPANY | 923 | $224K |
| Short-term disability(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 94 | $124K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 94 | $81K |
| Other(4 contracts, 4 carriers) | AMERICAN GENERAL LIFE INSURANCE COMPANY | 923 | $227K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 923 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.