| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| J J DOORHY BENEFITS GROUP3 | 1000 BURR RIDGE PARKWAY SUITE 202 BURR RIDGE, IL 60527 | BLUECROSS BLUESHIELD OF ILLINOIS | $49K | — | $49K | 2.50% |
| STERN INSURANCE GROUP INC3 | 11445 E VIA LINDA STE 2-611 SCOTTSDALE, AZ 852592839 | BLUECROSS BLUESHIELD OF ILLINOIS | $21K | — | $21K | 1.06% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: WORLD INSURANCE ASSOCIATES | 100 WOOD AVE S FL 4 ISELIN, NJ 08830 | BLUECROSS BLUESHIELD OF ILLINOIS | $6K | — | $6K | 0.32% |
| STERN INSURANCE GROUP INC3 | 11445 E VIA LINDA STE 2-611 SCOTTSDALE, AZ 852592839 | PRINCIPAL LIFE INSURANCE COMPAN | $4K | $5K | $9K | 4.95% |
| PARAGON PARTNERS LTD3 Filed as: PARAGON PARTNERS | STE C-103 9420 E DOUBLETREE RANCH RD SCOTTSDALE, AZ 852585589 | PRINCIPAL LIFE INSURANCE COMPAN | — | $8K | $8K | 4.40% |
| J J DOORHY BENEFITS GROUP3 | 1000 BURR RIDGE PKWY STE 203 BURR RIDGE, IL 60527 | PRINCIPAL LIFE INSURANCE COMPAN | $6K | — | $6K | 3.22% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SUN LIFE ASSURANCE COMPANY OF CANAD EIN 38-1082080 N/A | Claims processing Service code 12 | — | $1K |
| BLUE CROSS BLUE SHIELD OF ILLINIOS EIN 36-1236610 N/A | Non-monetary compensation Service code 56 | — | $0 |
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 | 83 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 86 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 252 | $1.9M |
| Dental | PRINCIPAL LIFE INSURANCE COMPAN | 254 | $180K |
| Vision | PRINCIPAL LIFE INSURANCE COMPAN | 254 | $180K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPAN | 254 | $180K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPAN | 254 | $180K |
| Other | PRINCIPAL LIFE INSURANCE COMPAN | 254 | $180K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 254 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.