| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AON CONSULTING INC3 | PO BOX 905494 CHARLOTTE, NC 28290 | BLUE CROSS BLUE SHIELD OF IL | $32K | — | $32K | 1.05% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E GOLF RD SCHAUMBURG, IL 60173 | BLUE CROSS BLUE SHIELD OF IL | $23K | — | $23K | 0.75% |
| AON CONSULTING INC3 | 29840 NETWORK PLACE CHICAGO, IL 60673 | LIFE INSURANCE CO OF NORTH AMERICA | $5K | — | $5K | 5.11% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E GOLF RD SCHAUMBURG, IL 60173 | LIFE INSURANCE CO OF NORTH AMERICA | $491 | $923 | $1K | 1.59% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E GOLF RD SCHAUMBURG, IL 60173 | VISION SERVICE PLAN | $925 | — | $925 | 2.65% |
| AON CONSULTING INC3 | 29840 NETWORK PL CHICAGO, IL 60673 | VISION SERVICE PLAN | $602 | — | $602 | 1.73% |
| AON CONSULTING INC3 | 29840 NETWORK PLACE CHICAGO, IL 60673 | LIFE INSURANCE CO OF NORTH AMERICA | $834 | — | $834 | 3.03% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E GOLF RD SCHAUMBURG, IL 60173 | LIFE INSURANCE CO OF NORTH AMERICA | — | $304 | $304 | 1.10% |
| AON CONSULTING INC3 | 29840 NETWORK PLACE CHICAGO, IL 60673 | LIFE INSURANCE CO OF NORTH AMERICA | $132 | — | $132 | 3.14% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY | 1750 E GOLF RD SCHAUMBURG, IL 60173 | LIFE INSURANCE CO OF NORTH AMERICA | — | $51 | $51 | 1.21% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY, LTD | 1750 EAST GOLF RD SCHAUMBURG, IL 60173 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1 | $1 | 1.23% |
| ASSURANCE AGENCY LTD3 Filed as: ASSURANCE AGENCY, LTD | 1750 EAST GOLF RD SCHAUMBURG, IL 60173 | LIFE INSURANCE CO OF NORTH AMERICA | — | $12 | $12 | — |
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 | 200 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 201 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF IL | 488 | $3.0M |
| Vision | VISION SERVICE PLAN | 200 | $35K |
| Life insurance | LIFE INSURANCE CO OF NORTH AMERICA | 223 | $89K |
| Long-term disability | LIFE INSURANCE CO OF NORTH AMERICA | 216 | $28K |
| Other(4 contracts, 2 carriers) | LIFE INSURANCE CO OF NORTH AMERICA | 295 | $93K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 488 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.