| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STEPHEN MONGIE4 | 3000 N UNIVERSITY AVE 350 PROVO, UT 84604 | BENEFICIAL | $5K | — | $5K | 1.50% |
| ARNETT INSURANCE SERVICES LLC3 Filed as: ARNETT INSURANCE SERVICE | 3850 E BASELINE ROAD 106 MESA, AZ 85206 | BENEFICIAL | $4K | — | $4K | 1.31% |
| MICHAEL R BERGERON3 | 2975 W EXECUTIVE PARKWAY STE 320 LEHI, UT 84043 | BENEFICIAL | $1K | — | $1K | 0.39% |
| JOEL GUTHMANN3 | 501 S TOWANDA BARNES RD BLOOMINGTON, IL 61704 | PENN MUTUAL | $643 | — | $643 | 0.53% |
| BENJAMIN WILLIAMS3 | 501 S TOWANDA BARNES RD BLOOMINGTON, IL 61704 | PENN MUTUAL | $472 | — | $472 | 0.39% |
| RANDALL OBRIEN3 | 4341 ACER GROVE DR STE 300C SPRINGFIELD, IL 62711 | PENN MUTUAL | $440 | — | $440 | 0.36% |
| MARK DELGUERCIO3 | 501 S TOWANDA BARNES RD BLOOMINGTON, IL 61704 | PENN MUTUAL | $421 | — | $421 | 0.35% |
| BRADLEY TERRY3 | 226 W ELDORADO DECATUR, IL 62522 | PENN MUTUAL | $383 | — | $383 | 0.31% |
| NICOLE WATSON3 | 501 TOWANDA BARNES ROAD BLOOMINGTON, IL 61705 | PENN MUTUAL | $310 | — | $310 | 0.25% |
| PAUL FUNKHOUSER3 | 501 TOWANDA BARNES ROAD BLOOMINGTON, IL 61705 | PENN MUTUAL | $293 | — | $293 | 0.24% |
| KEITH KILMA3 | 501 S TOWANDA BARNES RD BLOOMINGTON, IL 61704 | PENN MUTUAL | $276 | — | $276 | 0.23% |
| JAMES PASSARELLI3 | 501 S TOWANDA BARNES RD BLOOMINGTON, IL 61704 | PENN MUTUAL | $155 | — | $155 | 0.13% |
| INSIGHT BENEFITS GROUP LLC3 | 501A S TOWANDA BARNES ROAD SUITE 3 BLOOMINGTON, IL 61705 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $13K | — | $13K | 19.55% |
| GALILEE BROKERS INTERNATIONAL LLC3 | PO BOX 5044 PEORIA, AZ 85385 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $164 | — | $164 | 0.24% |
| ARNETT INSURANCE SERVICES LLC3 Filed as: ARNETT INSURANCE SERV | 3850 E BASELINE RD SUITE 106 MESA, AZ 85206 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $45 | — | $45 | 0.07% |
| MICHAEL J. WOOLLEY3 | 96 S 100 E AMERICAN FORK, UT 84003 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $29 | — | $29 | 0.04% |
| SPENCER HALL3 | 627 E REDONDO AVE SALT LAKE CITY, UT 84105 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $28 | — | $28 | 0.04% |
| PURSHE KAPLAN STERLING INVES3 | 18 CORPORATE WOODS BLVD ALBANY, NY 12211 | JACKSON NATIONAL | $1K | — | $1K | 3.00% |
| RONALD KIRBY3 | 311 SW WATER ST 210 PEORIA, IL 61602 | AIG | $5K | — | $5K | 36.12% |
| MICHAEL GRAMM3 | 217 HIGHWAY 40 W WILLMAR, MN 562012707 | AIG | $4K | — | $4K | 32.01% |
| FRANK WAINSCOTT3 | 1100 BOULDERS PKWY STE 600 NORTH CHESTERFIELD, VA 232254060 | AIG | $4K | — | $4K | 27.09% |
| TREVOR SUTTERFIELD3 | 501 E 4TH ST BARTLESVILLE, OK 740033906 | AIG | $3K | — | $3K | 18.89% |
| RAUL MENDEZ3 | 11503 NW MILITARY HWY 201 SAN ANTONIO, TX 78231 | AIG | $2K | — | $2K | 12.24% |
| JAMES HINTZ3 | 14130 CHARTER LANDING CT MIDLOTHIAN, VA 231144682 | AIG | $719 | — | $719 | 5.23% |
| CRAIG NELSON3 | 1230 E 1350 N AMERICAN FORK, UT 84003 | AIG | $335 | — | $335 | 2.44% |
| THOMAS CENTORBI3 | 2958 WESTERLAND DR SAINT CHARLES, MO 63301 | AIG | $277 | — | $277 | 2.01% |
| CHRISTOPHER LUBBERS3 | 1603 CRAWFORD AVE PARSONS, KS 673573244 | AIG | $264 | — | $264 | 1.92% |
| CHRIS LOYD3 | PO BOX 4070 BARTLESVILLE, OK 740064070 | AIG | $125 | — | $125 | 0.91% |
| MERLE JONES3 | 575 MARSHALL DR SAINT ROBERT, MO 65584 | AIG | $107 | — | $107 | 0.78% |
| RANDALL OBRIEN3 | 4341 ACER GROVE DR STE 300C SPRINGFIELD, IL 627116343 | AIG | $77 | — | $77 | 0.56% |
| MEREDITH DEKKER3 | 1490 S PRICE RD 103 CHANDLER, AZ 85286 | AIG | $68 | — | $68 | 0.49% |
| RICHARD SCHLEICHER3 | 6800 PARK TEN BLVD STE 130E SAN ANTONIO, TX 78213 | AIG | $42 | — | $42 | 0.31% |
| JEFF ROLCZYNSKI3 | 1985 DEKALB AVE SYCAMORE, IL 60178 | AIG | $41 | — | $41 | 0.30% |
| REAGAN WAGNER3 | 6800 PARK TEN BLVD STE 130E SAN ANTONIO, TX 78213 | AIG | $40 | — | $40 | 0.29% |
| TOUCHSTONE MCDONALD3 | 6800 PARK TEN STE 130E SAN ANTONIO, TX 78213 | AIG | $40 | — | $40 | 0.29% |
| NANM LLC3 | 8400 E PRENTICE AVE STE 1250 GREENWOOD VILLAGE, CO 80111 | TRANSAMERICA | $299 | — | $299 | 2.29% |
| REBECCA MCKEEN3 | 501 S TOWANDA BARNES RD BLOOMINGTON, IL 61704 | TRANSAMERICA | $239 | — | $239 | 1.83% |
| MICHAEL P. OMALLEY3 | 8535 E HARTFORD DR STE 108 SCOTTSDALE, AZ 85255 | COLUMBUS LIFE | $298 | — | $298 | — |
| INVESTMENT PLANNERS INC.3 Filed as: INVESTMENT PLANNERS INC | 226 W ELDORADO ST DECATUR, IL 62522 | COLUMBUS LIFE | $128 | — | $128 | — |
| LEWIS M. KELLEY, JR.3 Filed as: LEWIS MILTON KELLEY, JR | 37417 N TOM DARLINGTON DR STE 2 CAREFREE, AZ 85377 | COLUMBUS LIFE | $53 | — | $53 | — |
| MICHAEL WAYNE NEWTON3 | 501 S TOWANDA BARNES RD BLOOMINGTON, IL 61704 | RELISTAR LIFE INSURANCE COMPANY | $97 | — | $97 | — |
| STEVEN PRUIETT3 | 501 TOWANDA BARNES ROAD BLOOMINGTON, IL 61705 | RELISTAR LIFE INSURANCE COMPANY | $41 | — | $41 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LEGACY BENEFIT PLANS EIN 80-0113411 CONTRACT ADMINISTRATOR | Plan Administrator Service code 14 | 501 TOWANDA BARNES ROAD BLOOMINGTON, IL 61705 | $633K |
| IBG ADMINISTRATIVE SERVICES LLC EIN 80-0113406 SUPPORT SERVICES | Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | 501 S TOWANDA BARNES ROAD BLOOMINGTON, IL 617054047 | $151K |
| GDAF, LLP EIN 20-3355912 NONE | Legal Service code 29 | 1 E WACKER DRIVE STE 1700 CHICAGO, IL 606011814 | $107K |
| BARNES & THORNBURG, LLP EIN 35-0900596 NONE | Legal Service code 29 | 11 SOUTH MERIDIAN ST INDIANAPOLIS, IN 462043535 | $35K |
| COME TO BUY, INC. EIN 37-1395322 NONE | Other services Service code 49 | 3006 GILL STREET E BLOOMINGTON, IL 61704 | $30K |
| MUTUAL BANK EIN 39-2004336 TRUSTEE | Trustee (bank, trust company, or similar financial institution) Service code 21 | 1701 S TOWANDA AVENUE BLOOMINGTON, IL 61701 | $26K |
| CHARLES SCHWAB EIN 94-1737782 NONE | Custodial (securities) Service code 19 | 211 MAIN STREET SAN FRANCISCO, CA 94105 | $21K |
| CLIFTON LARSON & ALLEN EIN 41-0746749 NONE | Accounting (including auditing) Service code 10 | — | $18K |
| IBG BENEFITS MANAGEMENT COMPANY INC EIN 66-0757514 PARTY-IN-INTEREST | Consulting (general) Service code 16 | 100 NORTH POINT CENTER EAST SUITE 310 ALPHARETTA, GA 30022 | $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 | 496 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(7 contracts, 7 carriers) | BENEFICIAL | 37 | $497K |
| Other(2 contracts, 2 carriers) | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | 436 | $68K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 436 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.