| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FRANK WAINSCOTT3 | 1100 BOULDERS PKWY STE 600 NORTH CHESTERFIELD, VA 232254060 | AIG | — | — | $0 | — |
| TREVOR SUTTERFIELD3 | 501 E 4TH ST BARTLESVILLE, OK 740033906 | AIG | — | — | $0 | — |
| TOUCHSTONE MCDONALD3 | 6800 PARK TEN STE 130E SAN ANTONIO, TX 78213 | AIG | — | — | $0 | — |
| JAMES HINTZ3 | 14130 CHARTER LANDING CT MIDLOTHIAN, VA 231144682 | AIG | — | — | $0 | — |
| RAUL MENDEZ3 | 11503 NW MILITARY HWY 201 SAN ANTONIO, TX 78231 | AIG | — | — | $0 | — |
| RANDALL OBRIEN3 | 4341 ACER GROVE DR STE 300C SPRINGFIELD, IL 627116343 | AIG | — | — | $0 | — |
| CHRIS LOYD3 | PO BOX 4070 BARTLESVILLE, OK 740064070 | AIG | — | — | $0 | — |
| CHRISTOPHER LUBBERS3 | 1603 CRAWFORD AVE PARSONS, KS 673573244 | AIG | — | — | $0 | — |
| RONALD KIRBY3 | 311 SW WATER ST 210 PEORIA, IL 61602 | AIG | — | — | $0 | — |
| MEREDITH DEKKER3 | 1490 S PRICE RD 103 CHANDLER, AZ 85286 | AIG | — | — | $0 | — |
| THOMAS CENTORBI3 | 2958 WESTERLAND DR SAINT CHARLES, MO 63301 | AIG | — | — | $0 | — |
| RICHARD SCHLEICHER3 | 6800 PARK TEN BLVD STE 130E SAN ANTONIO, TX 78213 | AIG | — | — | $0 | — |
| REAGAN WAGNER3 | 6800 PARK TEN BLVD STE 130E SAN ANTONIO, TX 78213 | AIG | — | — | $0 | — |
| MERLE JONES3 | 575 MARSHALL DR SAINT ROBERT, MO 65584 | AIG | — | — | $0 | — |
| JEFF ROLCZYNSKI3 | 1985 DEKALB AVE SYCAMORE, IL 60178 | AIG | — | — | $0 | — |
| STEPHEN MONGIE3 | 3000 N UNIVERSITY AVE 350 PROVO, UT 84604 | BENEFICIAL | $5K | — | $5K | — |
| MICHAEL R BERGERON3 | 2975 W EXECUTIVE PARKWAY STE 320 LEHI, UT 84043 | BENEFICIAL | $1K | — | $1K | — |
| ARNETT INSURANCE SERVICES LLC3 Filed as: ARNETT INSURANCE SERVICE | 3850 E BASELINE ROAD 106 MESA, AZ 85206 | BENEFICIAL | — | — | $0 | — |
| PURSHE KAPLAN STERLING INVES3 | 18 CORPORATE WOODS BLVD ALBANY, NY 12211 | JACKSON NATIONAL | $363 | — | $363 | — |
| CABOT LODGE SECURITIES LLC3 | 200 VESY STREET NEW YORK, NY 10281 | JACKSON NATIONAL | — | — | $0 | — |
| BENJAMIN WILLIAMS3 | 501 S TOWANDA BARNES RD BLOOMINGTON, IL 61704 | PENN MUTUAL | $472 | — | $472 | — |
| MARK DELGUERCIO3 | 501 S TOWANDA BARNES RD BLOOMINGTON, IL 61704 | PENN MUTUAL | $421 | — | $421 | — |
| BRADLEY TERRY3 | 226 W ELDORADO DECATUR, IL 62522 | PENN MUTUAL | $383 | — | $383 | — |
| JAMES PASSARELLI3 | 501 S TOWANDA BARNES RD BLOOMINGTON, IL 61704 | PENN MUTUAL | $155 | — | $155 | — |
| NICOLE WATSON3 | 501 TOWANDA BARNES ROAD BLOOMINGTON, IL 61705 | PENN MUTUAL | $66 | — | $66 | — |
| KEITH KILMA3 | 501 S TOWANDA BARNES RD BLOOMINGTON, IL 61704 | PENN MUTUAL | — | — | $0 | — |
| JOEL GUTHMANN3 | 501 S TOWANDA BARNES RD BLOOMINGTON, IL 61704 | PENN MUTUAL | — | — | $0 | — |
| PURSHE KAPLAN STERLING INVESTMENTS3 | 18 CORPORATE WOODS BLVD ALBANY, NY 12211 | TRANSAMERICA | $595 | — | $595 | — |
| REBECCA MCKEEN | 501 S TOWANDA BARNES RD BLOOMINGTON, IL 61704 | TRANSAMERICA | $10 | — | $10 | — |
| NANM LLC3 | 8400 E PRENTICE AVE STE 1250 GREENWOOD VILLAGE, CO 80111 | TRANSAMERICA | — | — | $0 | — |
| STEVEN PRUIETT3 | 501 TOWANDA BARNES ROAD BLOOMINGTON, IL 61705 | RELISTAR LIFE INSURANCE COMPANY | $152 | — | $152 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LEGACY BENEFIT PLANS EIN 80-0113411 CONTRACT ADMINISTRATOR | Plan Administrator Service code 14 | 501 TOWANDA BARNES ROAD BLOOMINGTON, IL 61705 | $597K |
| DUGGAN BERTSCH, LLC EIN 26-3963060 NONE | Legal Service code 29 | 303 W MADISON SUITE 1000 CHICAGO, IL 60606 | $202K |
| 1800 MD EIN 27-1532190 NONE | Other services Service code 49 | 6408 BANNINGTON RD CHARLOTTE, NC 28226 | $44K |
| CLIFTON LARSON & ALLEN EIN 41-0746749 NONE | Accounting (including auditing) Service code 10 | 301 SW ADAMS ST 1000 PEORIA, IL 61602 | $19K |
| LANER MUCHIN EIN 36-3088463 NONE | Legal Service code 29 | 515 N STATE STREET SUITE 2800 CHICAGO, IL 606544688 | $16K |
| BUSINESS INTELLIGENCE ASSOCIATES EIN 75-3128219 NONE | Accounting (including auditing) Service code 10 | 950 TRADE CENTER WAY SUITE 240 PORTAGE, MI 490020493 | $5K |
| US LEGAL SUPPORT EIN 76-0523238 NONE | Legal Service code 29 | PO BOX 4772-99 HOUSTON, TX 772104772 | $3K |
| CHARLES SCHWAB EIN 94-1737782 NONE | Custodial (securities) Service code 19 | 211 MAIN STREET SAN FRANCISCO, CA 94105 | $1K |
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 | 466 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 466 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(8 contracts, 8 carriers) | AIG | 26 | $0 |
| Other | RELISTAR LIFE INSURANCE COMPANY | 1 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 26 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.